Angina

Question 1

What drugs, would you as a GP prescribe for a patient with newly diagnosed angina?

Answer 1

Sublingual GTN PRN
B-blocker/CCB (1st line)
- if contraindicated: nicorandil, isosorbide mononitrate

Secondary prevention:

• Aspirin 75mg (clopidogrel if previous stroke pt)
• Statin
• Consider treatment with an angiotensin-converting enzyme (ACE) inhibitor for people with stable angina and diabetes mellitus

Question 2

What would you as a GP do for a patient with poorly controlled angina?

Answer 2

1. Ensure patient is taking maximum licensed or highest tolerated dose
2. If person is taking B-blocker –> add amlodipine
3. If person taking Ca channel blocker –> add B-blocker

If either drug contraindicated –> add long-acting nitrate

If 2 drugs don’t help, refer to cardiologist.