Anti-anginals

    Angina

        Angina pectoris is the disease of the coronary artery, the principal supplier of blood carrying oxygen from the left ventricle to all heart tissues including the ventricles themselves. This circulation maintains cardiac function. The coronary circulation should also be capable of reacting to sudden demands of heart due to enhanced activity. Typically the artery responds to normal and enhanced demands by dilatation. The process of vasodilatation has been developed to satisfy the needs of the heart during strenous activity. However, when the coronary artery becomes less efficient in supplying blood and oxygen to the heart muscles, the heart feels suffocated. Such condition may arise due to atheromatous deposits in the artery. Coronary atherosclerosis, one of the more prevalent cardiovascular diseases, develops with increasing age. A suffocated heart is short in oxygen and is called ischemic.

        Angina is the principal symptom of an ischemic heart. It is characterized by a sudden, severe pain originating in the chest, radiating through the left shoulder and running down the arm. The symptom has been described since 1772.

        Anti-anginal drugs mainly alleviate and prevent anginal attacks by dilating the coronoary artery. Such action replenishes the left ventricle tissues of fresh blood carrying oxygen and relieves anginal pain. Three classes of drugs are found to be efficient in this regard. These include organic nitrates, calcium channel blockers and b-adrenergic blockers. We will discuss the structure, activity and mechanism of action of these groups of drugs.

•     b-Adrenergic agents

        The use of b-adrenergic blockers as anti-anginal agents is limited to the treatment of exertion-induced angina. Propranolol is the prototype drug in this class. It is a drug that has been previously discussed and hence will not be further discussed.

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©2000 VCU School of Pharmacy
Revised: January 8, 2000
Questions or Comments : Dr. Umesh R. Desai