| Drug | Features |
| Nitrates: nitroglycerine (acts within minutes when given sublingually); isosorbide mono- and dinitrate are longer acting | Anti-anginal effect is due to decreased preload, which reduces myocardial oxygen demand; decreases coronary vasospasm in Prinzmetal’s angina; dilates epicardial coronary arteries |
| Calcium channel blockers | Non-dihydropyridines are preferred, such as diltiazem and verapamil |
| Beta blockers | Anti-anginal effect is due to beta 1 blockade: decreases heart rate and contractility, which decreases myocardial oxygen requirements; atenolol, metoprolol, carvedilol preferred |
| Ranolazine | Reduces sodium influx during ventricular depolarization by blocking Na channels; may prolong QTc; adverse effects include dizziness, edema, tinnitus, vertigo, constipation, dry mouth, asthenia, palpitations, hypotension |
| Dipyridamole (persantine) | Acts as a vasodilator and platelet inhibitor; inhibits the enzyme phosphodiesterase, increasing cAMP; adverse effects include dizziness, diarrhea, headache, flushing, arthralgia, bleeding tendencies |
| Ivabradine | Inhibits funny currents in the SA node, decreasing heart rate; levels are affected by drugs acting on Cyt P450 enzymes; adverse effects include blurred vision, gastrointestinal upset, AF, prolongation of QTc, bradycardia |
| Trimetazidine | Increases myocardial resistance to ischemia by decreasing beta oxidation of fatty acids, thereby decreasing oxygen demand; cytoprotective effect; adverse effects include nausea, vomiting, thrombocytopenia, agranulocytosis, hepatic dysfunction, and may worsen Parkinson syndrome |
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