Medical Pharmacology Chapter 9: 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, beta-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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