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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