Angina treatment drugs and doses table

Heart disease forces a person to seek help from a doctor more often, since sometimes chest pain becomes simply unbearable. If one person is already standing in the doctor’s office at the first ailment, then others wait until they can no longer endure it. One such disease that can suddenly manifest itself is angina pectoris. In order not to be afraid for your health, you need to know how to treat angina pectoris. Which drugs are better?

What kind of disease is this?

Angina pectoris is a cardiovascular disease that develops as a result of coronary heart disease. The myocardium does not receive the required volume of blood due to clogged vessels. Blood cannot flow properly and with sufficient force through the vessels, as they are clogged with sclerotic plaques. The lumen of blood vessels decreases, and this is fraught with the appearance of a number of other serious diseases of the cardiovascular system. If you start treatment on time, you can prevent the occurrence of an early stroke or heart attack. What medications should I take for angina?

How do drugs work for angina pectoris?

In the treatment of the disease, many different drugs are used, one way or another designed to ensure a high-quality supply of oxygen to the myocardium and organize the flow of a sufficient amount of blood.

Drugs for angina pectoris may belong to different groups, but their action is mainly aimed at eliminating the attack and improving the supply of oxygen to the heart. They reduce the heart rate, increase the amount of oxygen supplied and relieve pain.

Symptoms

Angina pectoris is popularly called “angina pectoris”, since the disease is caused by a list of characteristic symptoms:

• stabbing pain in the chest,
• the appearance of hypertension (headache, weakness in the legs, dizziness),
• profuse sweating,
• dyspnea,
• pale skin,
• cold sweat all over the body,
• uneven heart rhythm (arrhythmias and tachycardias),
• cyanosis of hands, lips, feet.

The list may be updated. With angina pectoris in adults, the pain is localized in the right side of the sternum, but can radiate to the left side, neck or shoulder.

The disease is accompanied by a feeling of compression behind the sternum. Many heart patients will not confuse this type of pain with any other.

Important! If pain appears due to heavy physical exertion, this may indicate the presence of coronary heart disease.

The diagnosis of angina pectoris, or “angina pectoris,” should be carried out by a cardiologist. To make an accurate diagnosis, the doctor needs to clarify the location of the pain and conduct an ECG, to exclude sternum injuries, the occurrence of intercostal neuralgia and myocardial infarction. Hypertension is a concomitant disease.

Classification of angina

Angina is divided into 2 main groups – stable and unstable angina.

1. Stable angina (angina pectoris)

Angina pectoris usually develops during a person’s physical exertion, strong experiences, stress, i.e. in cases where the heartbeat quickens and the heart muscle needs an increased amount of blood and oxygen.

Depending on the level of physical activity at which a person experiences chest pain, exertional angina is divided into 4 functional classes (FC):

Angina pectoris FC 1 (FC I) – characterized by rare attacks of pain, mainly with significant or excessive physical stress on the body;

Angina pectoris FC 2 (FC II) - characterized by frequent attacks of pain during minor physical exertion - climbing stairs to the 1st floor, brisk walking of about 300 meters or more. An attack can also begin in the first hours of a person’s wakefulness, when, turning on from a state of rest to normal mode, the rhythm of the heart increases, blood circulation increases and antifibrinolytic ability decreases (circadian rhythm of angina).

Angina pectoris FC 3 (FC III) - characterized by frequent attacks of pain with minor physical exertion - climbing the stairs to the 1st floor at the usual slow pace, brisk walking of about 150 meters or more.

Angina pectoris FC 4 (FC IV) - characterized by frequent attacks with minimal physical activity of a person or a state of rest (rest).

Unstable angina

Unstable angina is characterized by painful attacks of varying intensity, duration, and unpredictable occurrence, for example, at rest. Pain syndrome is more difficult to relieve when taking nitrates (nitroglycerin). The risk of developing myocardial infarction is higher, in contrast to the stable form of this pathology. Due to its properties, unstable angina has been divided into several different types:

2.1. New-onset angina (AF) – the development of a recurrent attack occurs 30-60 days after the first manifestation of pain.

2.2 Progressive angina (PA) – development occurs more often against the background of a stable form of angina, with an increase in functional class (FC).

2.3. Early post-infarction, postoperative angina - the development of pain syndrome occurs in the period from 3 to 28 days after myocardial infarction (according to the classification of domestic doctors), or from 1 to 14 days (NYHA classification).

2.4. Spontaneous angina (vasospastic, variant, Prinzmetal) - characterized by sudden attacks of chest pain for no apparent reason, most often at rest. Typically, vasospastic angina is not associated with atherosclerotic lesions of the coronary vessels. Its cause is predominantly spasms of the coronary vessels.

Drugs for the treatment of angina pectoris

Medicines for the treatment of angina pectoris are prescribed by the attending physician. Self-medication is prohibited. If the dose of the drug is incorrectly set, there is a possibility of increasing blood pressure or aggravating the situation. Hypertension contributes to the development of cardiovascular diseases.

Angina drugs are usually divided into three main groups:

• with antiangial properties,
• with thrombus-absorbing effect,
• with antiatherosclerotic effect.

A medicine for angina pectoris with high blood pressure with antiangial properties is responsible for increasing the amount of oxygen in the blood. The drugs reduce the oxygen demand of the heart muscles. This group includes three more types of drugs: blockers, nitrates and calcium antagonists.

Important! An increased level of cholesterol in the blood indicates that the blood vessels have blood clots. This sharply increases the risk of stroke or heart attack, so drugs with thrombus-absorbing and anti-atherosclerotic effects are introduced for treatment.

Previously, doctors used IVs, but now there are drugs that can be taken in tablet form.

Antianginal agents

Medicines for angina pectoris in this group are available in different formats. They can be purchased as:

1. capsules with prolonged effect,
2. spray,
3. tablets,
4. patch,
5. films,
6. ointments.

This variety is due to wide demand. A person should be comfortable using the chosen product, regardless of work or lifestyle. But it is worth considering that the drugs do not cure the disease, but prevent an attack. Over time, the body can get used to it, so you cannot increase the dosage on your own.

Nitroglycerine

Nitroglycerin is the main active ingredient that is part of antiangial drugs. This is the name of the drug of the same name. Nitroglycerin is found in Deponit, Gilustenone, Nitradisk and Nitrangin. Depending on the method of application, the frequency of use of such products varies:

• The drugs are placed in the form of tablets under the tongue. The effect occurs within 2-3 minutes. This remedy helps to quickly relieve pain. The duration of action of one tablet reaches 30 minutes.
• The spray is simply sprayed into the mouth. Begins to act in 1 minute.
• The films are glued to the oral mucosa. They last no more than 3-4 hours.
• Capsules must be taken on a regular basis. The dosage is calculated by the doctor.
• Patches or ointments are applied to dry skin, but are not as effective as capsules or sprays.

Analogs

If for some reason the patient cannot be treated with the above drugs, the doctor may prescribe him one of the analogues described below.

Isosorbide dinitrate

This type of anti-aginal drugs is produced in the form of capsules, sprays or tablets. Isosorbide dinitrate is part of Nitrosobid, Isoket or Izolong. Prescribe 20 mg 2-3 times a day. Take 2 hours before or after meals. If the doctor observes poor recovery dynamics, the dose is increased to 120 mg per day. To prevent the body from getting used to the drug, replace it with an analogue after 1 month. Drink according to the updated regimen, since the new drug may have a different dosage of the main substance.

Analogs

You can replace the above medications with the following medications.

Calcium antagonists (CA) and beta blockers (BB)

AKs help relieve vasospasm. They lower blood pressure, which has a beneficial effect on heart rate. The heart muscle needs less oxygen, since its work is not as active. Representatives of the group: Nifedipine, Verapamil and Diltiazem. Take no more than 2 tablets per day.

Analogs

You can replace the above medications with these medications.

Important! While taking blockers, it is necessary to regularly monitor your pulse, as it increases. Normal is 50-60 beats per minute.

Blockers are recommended to be taken with meals to reduce possible side effects. Anaprilin is considered the most popular and affordable drug.

Analogs

Instead of Anaprilin, the patient may be prescribed such pharmaceuticals.

Only the attending physician should select a suitable analogue.

Means for the prevention and treatment of disease

The main cause of the development of the disease is the narrowing of the lumen of the coronary artery due to the deposition of atherosclerotic plaques. Therefore, the main prevention of the development of angina pectoris and attacks of pain in the heart is the fight against atherosclerosis.

To do this, drugs from the statin group (lipid-lowering drugs) are used, which reduce the level of low-density lipoproteins, thereby preventing the deposition of fat in the artery walls and the occurrence of coronary artery disease. Medicines for angina pectoris will help cope with the pathological mechanism of pain development in humans.

The second group of drugs that prevent the development of angina pectoris are antiplatelet agents. These are derivatives of salicylic acid, which prevent platelets from sticking together inside blood vessels, preventing blood thickening and thrombosis, including coronary arteries.

Often, atherosclerotic plaques not only degenerate and are filled with connective tissue, but are also perceived by blood cells as a site of vascular damage, thereby activating the platelet system, which leads to vascular thrombosis at the site of atherosclerotic lesions.

Unlike slowly progressing atherosclerosis, thrombosis can cause a sharp narrowing of the lumen of the heart vessel, thereby aggravating the course of the disease. It is necessary to take antiplatelet agents for IHD for life.

To improve the function of the coronary arteries, vascular drugs (angioprotectors) can be prescribed. They improve vascular blood flow in tissues and organs, increase the tone of the vascular wall. You can take such drugs for other vascular pathologies.

To directly relieve an attack of heart pain, drugs of the nitrate group are traditionally used. These drugs release the molecule nitric oxide (NO), which has a powerful vasodilator effect on the coronary arteries, which helps to expand the lumen of the vessel, as well as improve blood flow in the myocardium, which leads to the disappearance of ischemic pain in coronary artery disease.

Long-acting nitrates are available for patients who experience long-term, severe, frequently recurring symptoms of the disease.

The danger of using such drugs is that in case of an unintentional overdose (for example, during a severe attack in order to relieve pain with a high dose of the drug), the patient may experience vascular collapse and loss of consciousness.

In such a situation, not only outside help is often needed, but also urgent medical consultation and emergency therapy. Nitrates must be taken sublingually - that is, under the tongue.

Also, for the purpose of vasodilation of the coronary arteries, in order to eliminate the symptoms of coronary artery disease, you can take calcium channel blocker tablets. They act on the smooth muscle cells of the coronary arteries, preventing vascular spasm.

If a patient with myocardial ischemia has hypertension or a previous myocardial infarction, which did not lead to a significant decrease in myocardial function, then it is rational for such patients to prescribe beta-blockers.

These drugs inhibit cardiac adrenergic receptors, thereby reducing the sympathetic effect on the organ. This leads to a decrease in heart rate and pulse. In turn, this leads to a more complete filling of the ventricles and atria of the heart, thereby increasing the ejection fraction, and hence the work of the body’s main pump.

But the most important thing is that this effect of beta-adrenergic receptor blockers significantly reduces the myocardial oxygen demand, which reduces symptoms of coronary artery disease and angina pectoris.

For angina pectoris, you can only take tablets, which is quite convenient for the patient.

Drugs for the treatment of angina pectoris are presented in the table.

Angina pectoris is a very unpleasant disease. The main difference between this disease and other pathologies that cause heart pain is the dependence of the pain on physical activity and the relief of the attack with medications. Also, the duration of an attack of pain during angina pectoris rarely exceeds 15-20 minutes.

Fortunately, medications used by doctors for angina pectoris can cope with the disease.

It is important to remember that only a doctor can determine which medicine for angina pectoris you need, as well as the dose of the drug, after a detailed diagnosis.

An independent decision to take medications and dose adjustment of a drug often only leads to progression of the disease and worsening of the course of IHD.

Therefore, if you suspect an angina attack, consult a doctor immediately! Do not self-medicate - it is deadly!

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Thrombosorbating drugs

A truly effective drug that fights blood clots is Aspirin acetylsalicylic acid, which can negatively affect the gastric mucosa.

For people with individual intolerance to this substance, doctors prescribe Clopidogrel. Its effect is not as aggressive, and it copes better with angina pectoris. The cost is considered average, since 28 tablets of Clopidogrel cost 400-500 rubles.

Analogs

Instead of Clopidogrel, the patient may be prescribed one of the drugs given in the table.

Antiplatelet agents

Antiplatelet agents can improve the rheological properties of blood by preventing the adhesion of formed elements, especially platelets. This reduces the risk of thrombosis and myocardial ischemia.

These angina medications can be used both to treat an acute attack and as one of the main drugs in a prophylactic regimen.

The main medications are:

• Acetylsalicylic acid (aspirin).
• Clopidogrel and others.

Aspirin

The cheapest and most accessible anticoagulant present in every first aid kit. According to statistics, the drug reduced the risk of mortality from acute myocardial infarction by 2 times. To relieve ischemic syndrome, high doses of medication are recommended - you need to take 325 mg tablets, while for the prevention of angina, a dose of 75 mg per day is sufficient.

The main medications containing aspirin in low dosages are: Aspirin Cardio, Cardiomagnyl, Magnicor and others. These medications, if IHD is diagnosed, are taken daily and for life.

Clopidogrel

Unlike aspirin, the medicine cannot be used to relieve an attack. Its accumulation occurs within 2-3 days of regular use, and the maximum pharmacological effect is achieved after six months of treatment.

In some cases, in order to treat stable angina, a combination of two drugs is used: Aspirin and Clopidogrel. However, in this case, the risk of developing side effects of drugs in the form of bleeding increases.

Drugs with antiatherosclerotic action

This group of medications is called statins. These substances fight bad cholesterol in the blood. When its amount is excessive, cholesterol settles on the walls of blood vessels, forming atherosclerotic plaques. These medications should be taken in the evening as they can cause muscle soreness and nausea. Representatives of this group are: Atorvastatin, Rosuvastatin, Fluvastatin. Drugs are prescribed only after a blood test for cholesterol.

The listed medications are basic. Specific drugs for treatment and their doses must be prescribed and strictly monitored by a cardiologist. You should not increase the dosage yourself or buy analogues. In addition to the main active ingredient, the drug may contain elements that cause side effects and complications.

Diagnosis of angina pectoris

Diagnosis of angina pectoris includes the following examination methods:

• Anamnesis;
• General blood analysis;
• Blood chemistry;
• Measuring blood glucose levels (determination of glycemia);
• Electrocardiography (ECG) at rest and during physical activity;
• Daily monitoring of heart function using ECG;
• Echocardiography (EchoECG) at rest and during exercise;
• Scintigraphy during physical or pharmacological stress.
• Coronary angiography (in some cases, at the discretion of the doctor).

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New products in the production of drugs for hypertension and angina pectoris

Drugs for angina pectoris with high blood pressure should be prescribed taking into account all contraindications and previous use of medications. The main thing is an integrated approach to the choice of treatment. The principles of treating blood pressure disorders and angina pectoris are similar. Modern pharmacists who are involved in the creation of antihypertensive drugs have already put drugs with a combined composition into production. This approach helped to rationally approach the problem of treating angina and hypertension. One drug now combines:

• Beta blocker and diuretic.
• Beta blocker and AK.
• ACE inhibitor and diuretic.
• ACE inhibitor and calcium antagonist.

Imidazoline receptor antagonists have become completely new drugs to combat angina pectoris disease and high blood pressure. The world is just waiting for the launch of these drugs into mass production while these innovations are going through the development stage. Drug treatment for angina and hypertension has become not only accessible, but also effective. Raise your health today!

Beta blockers

First-line drugs in the treatment regimen for stable angina. They reduce ischemia by reducing blood pressure, contraction frequency and myocardial contractility. They are used not only for prevention, but also for stopping a long-term acute attack in an inpatient department in the form of droppers.

Contraindications to the use of the drug are: atrioventricular block and other types of bradycardia, diseases accompanied by bronchial obstruction (asthma, COPD, etc.), hypotension, decompensated stage of heart failure, as well as cardiogenic shock.

Main drugs:

• Metoprolol.
• Bisoprolol.
• Atenolol and others.

Metoprolol

It is used for stable angina pectoris against the background of high blood pressure and arrhythmia. Helps reduce myocardial oxygen demand by reducing the work of the cardiac muscles (contractility and contraction frequency are reduced, which allows an increase in end-diastolic volume).

It is used both as a stand-alone drug and in combination with other drugs. It is administered intravenously in a hospital setting under the control of blood pressure and heart rate.

Unconventional treatment

To enhance the therapeutic effect of medications, patients with angina pectoris can use decoctions and infusions with:

1. Astragalus wooliflorum. The plant quickly reduces pressure in the arteries and has an antiarrhythmic effect.
2. Small periwinkle. Has the same effect as astragalus.
3. Birch buds. 30 grams of birch leaves need to be poured with 250 boiling water, left for half an hour and taken 2 tablespoons every three hours.
4. Blood red hawthorn. 20 grams of hawthorn flowers are steamed with 0.5 liters of boiling water, left for 25 minutes and taken 25 ml three times a day after meals.
5. Three-leaf watch. It is enriched with alkaloids, therefore it has a positive effect on the cardiovascular system.
6. Curly parsley. It contains substances that act like cardiac glycosides. To prepare a medicinal drink, you need to throw 30 grams of parsley root into 250 ml of boiling water, boil for 10 minutes, cool and strain. Take 125 ml daily.
7. Pharmacy chamomile.

Aromatherapy sessions will not be superfluous. Essential oils of lemon balm and mint calm the nervous system and improve the condition of blood vessels. With the permission of the doctor, patients can perform special breathing exercises.

Reviews

The cardiologist prescribed the grandmother to take Clopidogrel one tablet a day for the purpose of prevention. This medication cannot be purchased without a prescription. After taking the first pill, my grandmother developed an allergy, but then everything went away. He has been taking the medicine for several months. The only drawback is the high price.

Angelina, student

After a stroke, my mother was prescribed Atorvastatin. It does not give any positive effect and only provokes vomiting. Mom drank it for three months, but her cholesterol didn’t even think about decreasing. One advantage of the medicine is its low price. We will ask the doctor to prescribe an analogue, otherwise we no longer have the strength.

Ksenia, 36 years old

Precautionary measures

As practice shows, many patients ignore the presence of angina pectoris due to expensive treatment. This attitude towards health can have very disastrous consequences. If the prescribed drugs are beyond your means, ask your specialist to find a cheaper alternative.

Another harmful action performed by patients is self-adjustment of drug dosage. Only a qualified specialist has the right to make changes to treatment.