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Clinical Application Page 1 of 41 Pharmacokinetics, Drugs Clinical Uses Mechanism Effects Toxicities, Adverse Trade Application of Action Interactions Reaction Name Category: ANGINA PECTORIS BETA BLOCKERS Prophylaxis of angina Cardiac arrhythmias, Nonselective Decreased heart rate, Oraland parenteral, Fatigue, weaknesses, Inderal, inderal angina pectoris, competitive cardiac output, and duration 4-6 h nausea, vomiting, LA, Propranolol, hypertension, antagonist β blood pressure, *Toxicity: asthma, depression, Atenolol essential tremor, adrenoceptors decreases myocardial atrioventricular block, bradycardia, dizziness, myocardial infarction, oxygen demand acute heart failure; vertigo, rash, decrease pheochromocytoma sedation*Interactions: libido, hypotension, Additive with all hyperglycemia, cardiac depressants decrease exercise tolerance, proarrhythmic effects CALCIUM CHANNEL Prophylaxis of Vasospastic angina Block vascular L- Like verapamil and Oral, duration 4-6 h Dizziness, Nifedipine, BLOCKERS angina, hypertension (Prinzmetal's variant type calcium diltiazem; less cardiac *Toxicity: Excessive lightheadedness, Adalat, angina), chronic stable channels > cardiac effects hypotension nervousness, procardia, angina, hypertension channels *Interactions: Additive headache, nausea, procardia XL, with other vasodilators constipation, dihydropyridine peripheral edema, asthenia, bradycardia, atrioventricular block, arrhythmias, flushing CALCIUM CHANNEL Prophylaxis of Angina pectoris, Nonselective block Reduce vascular Oral, IV, duartion 4-8 h Dizziness, light Verapamil BLOCKERS angina, hypertension arrhythmia, essential of L-type calcium resistance, cardiac *toxicity: headedness, (Calan, isoptin, hypertension, atrial channels in vessels rate, and cardiac Atrioventricular block, nervousness, verelan), flutter/fibrillation and heart force results in acute heart failure; bradycardia, flushing, Diltiazem decreased oxygen constipation,edema rash (Cardizem, demand *Interactions: Additive dilacor XR) with other cardiac depressants and hypotension Page 1 of 41 Pharmacokinetics, Drugs Clinical Uses Mechanism Effects Toxicities, Adverse Trade Application of Action Interactions Reaction Name MISCELLANEOUS for angina Inhibit late Na+ Reducescardiac Oral, duration 6-8 h * Prophylaxis of angina, No significant ivabradine Ranolazine current in heart, also oxygen demand, Toxicity: QT interval hypertension hemodynamic effects may modify fatty acid fatty oxidation prolongation, nausea, oxidation, reduce modification may constipation, contractility improve efficiency dizziness of cardiac oxygen *Interactions: utilization Inhibitors of CYP3A increase ranolazine concentration and duration of action NITRATES Angina: Sublingual Treatment and Release nitrate Smooth muscle very high first pass headache, Nitroquick, dose form for acute prevention of angina oxide in smooth relaxation especially, effect, so sublingual hypotension, nitrostat, episodes *oral and pectoris muscles, which in vessels, other dose is much smaller dizziness, weakness, nitrolingual, transdermal forms activate guanylyl smooth muscle is than oral, high lipid flushing, restlessness isodril, dilatrate, for prophylaxis cyclase and relaxed but not as solubility ensures nitroglycerin, increased cGMP markedly, rapid absorption * isosorbide vasodilation Toxicity: Orthostatic dinitrate, decreases venous hypotension, isosorbide return and heart size tachycardia, head mononitrate , may increase ache * Interaction: coronary flow in Synergistic some areas and in hypotension with variant angine phosphodiesterase type 5 inhibitors (Sildenafil, etc.
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