1. organic nitrites/nitrates

2. BB

3. CCB

Restore balance bw mycardial O2 supply and demand.

-incr supply or decr demand

1. isosorbide dinitrate

2. isosorbide mononitrate

3. NTG

4. amyl nitrate (inhaled volatile liquid ST

acute attack)

1. Dilate lg veins (decr preload)

2. Dilate coronary vasc (incr supply to heart)

1. Classic-decr demand and tension

2. Variant-incr O2 supply

use smallest effective dose,

and admin. as infrequent as possible.

**nitrate free period recommended

terminate ongoing acute attack

*can be used proplyactically

provide sustained protection against attack

(admin fixed schedule to allow for

NTG free period)

 **D/C SLOWLY to prevent vasospasm!

Nifidipine

Nimodipine

Amlodipine

Nicardipine

Verapamil

Diltiazem

MOA CCB's

Bind to L-type Ca channels-> prevent

entry of Ca = Decr tone and resistance

**Dihydropyridines: potent vasodilators

-> decr BP and cause reflex tachy

art. vasodilators

flushing, HA, hypotn, peripheral edema

**may cause reflex tachy

typical and variant angina

***CAUTION in CHF or AV abn pts

Which non dihydro has constipation

as a SE?

verapamil

diltiazem

atenolol

metoprolol

nadolol

propranolol

Uses for BB in tx angina

decr attacks

decr NTG useage

incr exercise tolerance

decr pain by decr O2 demand

reduce work by decr CO, and reducing afterload

=decr O2

***useful in post MI

pindolol

acebutol

DM and COPD/asthma

NTG

CAUTION w/ CCB's!