Nursing Pharmacology Chapter 9:  Antianginal Drugs

• Angina: Treatment Objectives and Approaches: Treatment objectives include both acute management and prevention of anginal episodes:

  • Acute Management

    • These agents cause systemic venodilation and therefore reduce myocardial wall tension and oxygen requirements

    • Nitrates dilate epicardial coronary capacitance vessels thereby increasing blood flow in collateral vessels.

    • Although other nitrates may be used in management of angina, other preparations are less effective in acute management.

• Chronic Management

  • Medical management is individualized for each patient, including patient education and counseling to assist in reduction of risks of coronary heart disease.

  • Risk management includes:

    • Optimal treatment or elimination of co-existing illness such as diabetes mellitus and hypertension.

    • Dietary and drug therapy of dyslipidemias

    • Smoking cessation

    • Adapation of activities, such as increasing the amount of time needed to accomplish a task which if performed more rapidly could induce angina.

Selwyn, A.P. and Braunwald, E Ischemic Heart Disease in Harrison's Principles of Internal Medicine (Isselbacher et al., eds) McGraw-Hill, Inc., New York, 1994, p 1081-2.