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Drugs for Angina Treatment
July 1, 2009 | Leave a Comment
Angina pectoris
angina pectoris is a painful cardiac condition that occurs when the work load on the heart and the onsequent oxygen demand of the myocardium exceed the ability of the cardiovascular system to meet that demand. The pain may vary from a relatively mild ache to a crushing chest pain which may radiate to the left shoulder and left arm and other areas. It is often triggered off by exertion, and usually subsides rapidly
with rest. It is basically a stress response to factors that increase cardiac demand and output, and is often linked with an atheromatous narrowing of the coronary arteries.
Treatment of angina is with coronary vasodilator drugs that reduce cardiac drive and
lower the myocardial oxygen demand (many of which are also used in the treatment of hypertension – see page 148. They include the time-honoured glyceryl trinitrate (which can be given by several routes), other nitrates, calcium channel blocking agents, beta-adrenergic receptor blocking agents and potassium channel activators.
Glyceryl trinitrate is of particular value when a rapid response is required. The following Table gives an indication of the wide range of anti-anginal products currently available.
sublingual tablets 300, 500, 600 mg spray 400 mg/dose spray 400 mg/dose 400 mg/dose
long-acting tablets, 6.4 mg long-acting tablets, I mg, 3 mg, 5 mg long-acting tablets, 2.6 mg, 6.4 mg
IM9 1 mg
patches 5 mg
patches 5 mg, 10 mg, 15 mg
patches 2.5 mg, 5 mg, 10 mg, 15 mg patches 5 mg, 10 mg
ointment 2%
glyceryl
trinitrate Coro-Nitro Spray* Glytrin Spray Nitrolingual Spray
Nitro-Continua Suscard
Sustac
Nitrocine injection Nitronal injection
Deponit
Minitran
Nitro-Dur Trasiderm-Nitro
Percutol
Note: Sprays (1 -2 doses) are given under the tongue; the mouth should then be closed.
sorbide Isordil tablets 5mg, 10 mg, 30 mg
idinitrate Sorbichew tablets 5 mg
Sorbitrate tablets 10 mg, 20 mg
long-acting products Cedocard-Retard 20 mg, 40 mg
Isoket Retard 20 mg, 40 mg
Isordif Tembids 40 mg
Sorbid-SA 20 mg, 40 mg
Isoket injection 500 mg
tablets 10, 20, 40 mg tablets 10, 20, 40 mg tablets 20mg
tablets 10, 20mg
tablets 10, 20, 40 mg
long-acting products
capsules 25 mg, 50 mg
capsules 60 mg tablets 40 mg capsules 50 mg tablets 40 mg capsules 40mg
Table 4 Drugs used in angina. Continued over.
isosorbide mononitrate
Elantan
Ismo
Isotrate
Monit Mono-Cedocard
Elantan LA lmdur
Ismo Retard MCR-50
Monit SR Monomax SR
pentaerythritol Mycardol tablets 30 mg tetranitrate
acebutolol Sectral capsules 100mg, 200mg tablets 400 mg
atenolol Tenormin tablets 25, 50, 100mg
bisoprolol Emcor, Monocr tablets 5 mg, 10 mg
metoprolol Betaloc, Lopresor tablets 50 mg, 100 mg
nadolol Corgard tablets 40 mg, 80 mg
oxprenolol Trasicor tablets 20 mg, 40 mg, 80 mg
Slow-Trasicor tablets 160 mg
pindolol Visken tablets 5 mg, 15 mg
propranolol Inderal tablets 10, 40, 80 mg
Inderal-LA tablets 160 mg
amlodipine Istin tablets 5mg, 10 mg
dittiazem Adizem tablets 60 mg
Tildiem tablets 60 mg (long-acting diltiazem products are:
Adizem-XL AAngil SR Calcicard CR, Diazem SR, Diazem XL, Slozem,
Tildiem LA, Tildiem Retard)
felodipine Plendil tablets 5 mg, 10 mg
Anicardipine Cardene tablets 20 mg, 30 mg
nifedipine Adalat capsules 5mg, 10 mg (long-acting nifedipine products are:
Adalat LA, Adalat Retard, Adipine MR, Angiopine MR, Cardilate MR,
Coracten, Hypolar Retard, Nifelease, Nifensar XL, Unipine XL)
(verapamil Cordilox tablets 40, 80, 120, 160 mg
Securon tablets 40 mg, 80 mg, 120 mg:potassium channel activator
nicorandil Ikorel tablets 10mg, 20mg