Anesthesia Pharmacology: Antianginal Drugs
Pharmacology of ß-Adrenoceptor Antagonists: Antianginal Effects
Overview
β-adrenoceptor antagonists are beneficial in reducing:
Frequency of anginal episodes
Severity of exertional angina attacks
Not effective in variant angina (may even worsen condition)
Effective antianginal drugs:
Propranolol (Inderal)
Metoprolol (Lopressor)
Timolol (Blocadren)
Atenolol (Tenormin)
Antianginal effects of β-blockers are due to:
Decreased heart rate
Decreased contractility
Decreased blood pressure during exercise (reduced afterload)
β-adrenoceptor antagonists may be used in combination with nitrates and calcium channel blockers in select patients
Harmful effects
In patients with significantly reduced left ventricular function and limited myocardial reserve, β-receptor blockade may precipitate heart failure by blocking essential sympathetic drive.
Note, however, that beta-receptor antagonists are important drugs in management of congestive heart failure in many patients.
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