Antianginal Drugs
Antianginal Drugs
OVERVIEW Angina pectoris is a characteristic chest pain caused by coronary blood flow that is insufficient to meet the oxygen demands of the myocardium
OVERVIEW ◼ Angina pectoris is a characteristic chest pain caused by coronary blood flow that is insufficient to meet the oxygen demands of the myocardium
ORGANIC NITRATES Organic nitrates are simple nitric and nitrous acid esters of alcohols.These compounds cause a rapid reduction in myocardial oxygen demand followed by rapid relief of symptoms.They are effective in stable and unstable angina, as well as Prinzmetal's or variant angina pectoris
ORGANIC NITRATES ◼ Organic nitrates are simple nitric and nitrous acid esters of alcohols. These compounds cause a rapid reduction in myocardial oxygen demand followed by rapid relief of symptoms. They are effective in stable and unstable angina, as well as Prinzmetal's or variant angina pectoris
Nitroglycerin Nitrates,beta-blockers,and calcium channel blockers are equally effective for relief of anginal symptoms.However, for prompt relief of an ongoing attack of angina precipitated by exercise or emotional stress,sublingual (or spray form)nitroglycerin is the drug of choice
Nitroglycerin ◼ Nitrates, beta-blockers, and calcium channel blockers are equally effective for relief of anginal symptoms. However, for prompt relief of an ongoing attack of angina precipitated by exercise or emotional stress, sublingual (or spray form) nitroglycerin is the drug of choice
Mechanisms of action nitroglycerin are thought to relax vascular smooth muscle by their intracellular conversion to nitrite ions and then to nitric oxide(NO),which in turn activates guanylate cyclase and increases the cells'cyclic GMP. Elevated cGMP ultimately leads to dephosphorylation of the myosin light chain, resulting in vascular smooth muscle relaxation
Mechanisms of action ◼ nitroglycerin are thought to relax vascular smooth muscle by their intracellular conversion to nitrite ions and then to nitric oxide (NO), which in turn activates guanylate cyclase and increases the cells' cyclic GMP. Elevated cGMP ultimately leads to dephosphorylation of the myosin light chain, resulting in vascular smooth muscle relaxation