Faculty of Pharmacy - Menoufia University

Department of ……………
Code (PC805)

(Antianginal Drugs)

Student Name: ‫أحمد سمير عبدالمقصود محمود عبده‬

Grade: (‫)الثالثة‬

Academic number: (16015)

National ID: (29811231400734)

This research Under the Supervision of

Professor Name

Second Semester
2019/ 2020
Abstract
Antianginal drugs are those that prevent, abort or terminate attacks of angina
pectoris, Current guidelines recommend pharmacological therapy with drugs
classified as being first line (beta blockers, calcium channel blockers, short
acting nitrates) or second line (long-acting nitrates, ivabradine, nicorandil,
ranolazine, and trimetazidine). Second line drugs are indicated for patients who
have contraindications to first line agents, do not tolerate them or remain
symptomatic.

Introduction
treatment of patients with angina is rapidly evolving because of number of
reasons. Not only have the number of drugs available increased dramatically,
but the use of older, time-tested agents (the nitrates) has become more clearly
defined. Furthermore, a whole new group of drugs (the calcium antagonists) are
being pursued based on our newer appreciation of the significant role that
coronary vasospasm might play in various anginal syndromes. The first
effective treatment for angina, amyl nitrate, was described in 1867, and
subsequently in 1879 the benefits of nitroglycerine were reported. However, it
was not until 1964 that propranolol, the first clinically available beta blocker,
was introduced into clinical practice for the long term oral management of
chronic stable angina. Calcium antagonists were identified in 1964 and in 1975
became available, licenced for the treatment of angina. Around this time, long
acting nitrates in the form of isosorbide dinitrate began to be used for chronic
oral therapy; the earlier preparations of long-acting nitrates were hampered by
the development of drug tolerance.(1,2,3)
 Classifications

Nitrates Glyceryl Isosorbide Pentaerythrit mononitrate Isosorbide

trinitrate dinitrate ol
tetranitrate
Βeta Propranolol Metoprolol Atenolol
Blockers
Calcium Verapamil Diltiazem Nifedipine Felodipine Amlodipine
channel
blockers
Potassium Nicorandil
channel
opener
Others Dipyridamole Trimetazidine Ranolazine Oxyphedrine Ivabradine

Structures

References
1- Lauder Brunton T. On the use of nitrite of amyl in angina pectoris. Lancet
1867;90:97–98.
2- Murrell W. Nitroglycerine as a remedy for angina pectoris. Lancet
1879;113:225–227.
3- Srivastava SC, Dewar HA, Newell DJ. Double-blind trial of propranolol
(Inderal) in angina of effort. Br Med J 1964;2:724–725.