Antianginal Treatment

Question 1

Beta-Blockers

• MOA
• Notes
• When to avoid?

Answer 1

• ↓ HR, ↓ contractility, ↓Myocardial demand, ↓ LV wall tension
• 1st line in SIHD
• BBs w/o ISA preferred (Metoprolol, Atenolol)
• Avoid in Prinzmetal’s angina

Question 2

CCBs

• MOA
  
  • Non-DHP
  • DHP
• Notes

Answer 2

• ↓ Oxygen demand
  
  • Non-DHP ↓ HR & contractility
  • DHP ↓ SVR (afterload)
• Avoid short-acting (Nifedipine IR)
• Preferred choice in Prinzmental’s angina
• DHPs preferred when CCBs used w BBs