Back one screen: left arrow Back to main menu: ESC DRUG SELECTION IN ANGINA A. Atheroscler

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Back one screen: left arrow Back to main menu: ESC DRUG SELECTION IN ANGINA A. Atherosclerotic angina: 1. Treatment of the acute attack: * Nitrates: sublingual nitroglycerine or isosorbide. * Calcium channel blockers: sublingual nifedipine. 2. Prophylaxis: (Combination of 2 groups more effective than a single group) * Nitrates: oral, topical ointment, or transdermal nitroglycerine, oral isosorbide dinitrate. * Beta blockers: oral propranolol, nadolol. * Calcium channel blockers: oral diltiazem, nifedipine, or verapamil. B. Vasospastic angina: 1. Treatment of the acute attack: * Nitrates: sublingual nitroglycerine, isosorbide. * Calcium channel blockers: diltiazem, nifedipine, verapamil. 2. Prophylaxis: * Calcium channel blockers: diltiazem, nifedipine, verapamil. * Nitrates: buccal, oral, or topical nitroglycerine. C. Unstable angina: * Nitrates: intravenous nitroglycerine. * Calcium channel blockers: oral verapamil. * Beta blockers: propranolol. * Adjunctive therapy: Aspirin, heparin. References: 1. Symposium: Circulation 1985; 72 (Suppl V). 2. Takaro T et al: The Veterans Administration Cooperative Study of Stable Angina: Current status. Circulation 1982; 65 (Suppl 2): 60. 3. Gersh B J et al: Comparison of coronary artery bypass surgery and medical therapy in patients 65 years of age or older. N Engl J Med 1985;313:217. 4. Morse JR, Nesto RW: Double-blind crossover comparison of the antianginal effects of nifedipine and isosorbide dinitrate in patients with exertional angina receiving propranolol. J Am Coll Cardiol 1985; 6: 1395. Back to Table of Contents

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