Drug of choice for classical angina attack -

Ans. is 'c' i.e., GTN PHARMACOLQG1CALTREATMENT OF STABLE (CLASSICAL ANGINA)o For immediate pre-cxcrtional prophylaxis and acute attack1. Sublingual glyceral trinitrate (Drug of choice)o Acts by decreasing preload (LV filling pressure - i myocardial oxygen demand),o Also cause redistribution of blood flow to the ischemic zone by dilating conducting coronary vessels.Nifedipine by bite capsuleo Decrease myocardial oxygen demand by decreasing contractility and arterial pressure,o Also dilates coronary artery.o For long term prophylaxisb-blockers (DOC)o They reduces the myocardial oxygen demand by inhibiting the increase in heart rate, arterial pressure and myocardial contractility caused by adrenergic stimulation.CCBso Are used if coronary spasm is suspected or (3-blockers are contraindicated.Long acting nitrateso Usually avoided because of development of tolerance.Nicorandil (Potassium-channel opener)o Decreases preload (venodilatation) and L.V. filling pressure - i myocardial oxygen demand.ACE inhibitorso Particularly useful in patient at increased risk, especially if DM or LV dysfunction is present, and in those who have not achieved adequate control of blood pressure by b-blockers.