Medical therapy: treatment of angina pectoris

MEDICAL THERAPY: TREATMENT OF ANGINA PECTORIS
Medical treatment of ischaemic heart disease has to take two forms: chronic long-term treatment for angina pectoris and intensive emergency treatment for myocardial infarction.
TREATMENT OF ANGINA PECTORIS
Q. What are the objectives of medical treatment of angina ?
A. The medical treatment of angina is directed towards:
* Alleviation and prevention of attacks of angina.
* Increasing exercise tolerance.
* Prevention of myocardial infarction.
Q. How are the attacks of angina treated ?
A. The aim of the treatment is to prevent the attacks from occurring as far as possible and to control the attack if and when it occurs. The sheet-anchor of the treatment is nitrates. The short but quick acting nitrates such as nitroglycerine (Angesid) are used to treat the attack. The drug is kept under the tongue, which causes rapid absorption of the drug so that the effects appear within a couple of minutes. The patient should also stop all activity in order to reduce the oxygen demand of the heart. The medium acting nitrates, such as isosorbide dinitrate (sorbitrate), and longer acting nitrates such as mononitrate are used to prevent attacks of angina from reoccurring. Nitrates are drugs which ought to be given freely. The patient can and should take more than the dose prescribed, if necessary, without hesitation, The only side effect is headache, which is harmless and gradually becomes less and less troublesome.
Other drugs used for the treatment of angina are calcium channel blockers (nifedipine, diltiazem) and betablockers (Atenolol, Inderal).
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