4. Anti- Anginal Drugs: Calcium Channel Blockers: CVS Pharmacology

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4. Anti- Anginal Drugs: Calcium Channel Blockers: CVS Pharmacology
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Calcium Channel Blockers (CCBs) are essential anti-anginal drugs that work by inhibiting L-type calcium channels in vascular smooth muscle and cardiac cells, leading to vasodilation, reduced myocardial oxygen demand, and improved coronary blood flow ????????.

CCBs are classified into dihydropyridines (DHPs), such as amlodipine, nifedipine, and felodipine, which primarily cause arterial vasodilation, and non-dihydropyridines (Non-DHPs), such as verapamil and diltiazem, which have negative inotropic, chronotropic, and dromotropic effects, reducing heart rate and myocardial contractility ????????.

DHPs are highly effective in stable angina and hypertension, as they reduce afterload and coronary vasospasm, whereas Non-DHPs are preferred in variant (Prinzmetal’s) angina and arrhythmias, due to their ability to decrease heart rate and AV nodal conduction ????????. By blocking calcium influx, CCBs help prevent coronary artery spasm, making them the first-line treatment for vasospastic angina ????????. Side effects of DHPs include peripheral edema, reflex tachycardia, flushing, and headache, while Non-DHPs can cause bradycardia, AV block, and constipation ????⚠️.

CCBs are contraindicated in severe heart failure, hypotension, and patients on beta-blockers (especially verapamil & diltiazem), as they may lead to excessive cardiac suppression ⚠️????. Unlike nitrates, CCBs do not cause tolerance, making them a crucial option for long-term angina management ????????. They are often used in combination with beta-blockers or nitrates for better angina control, improving patient outcomes and quality of life ❤️????.


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