Nursing Pharmacology Chapter 9:  Antianginal Drugs

• Pharmacology of ß Adrenoceptor Antagonists: Antianginal Effects

  • Overview

  • β-adrenoceptor antagonists are beneficial in reducing:

    • Frequency

    • 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.