4.1 ONLY Drugs & Actions (Slide 21)

Cox-1 inhibition, reduce thromboxane A2 production and platelet aggregation

Antiplatelet agents (asprin)

Stabilize coronary plaque and improve endothelial function

ARBs & ACEi

Reduce VSM cell proliferation and cardiac work (afterload)

ARBs & ACEi

Vasodilate (especially epicardial cardiac vessels)

Nitrates

Vasodilate (effects on VSM, including in heart), reduce cardiac work (afterload)

DHP CCBs

Vasodilate, Reduce myocardial work by decreasing contractility of cardiomyocytes

Non-DHP CCBs

Reduce HR (increase diastolic flow), reduce cardiac work (afterload)

β-Blockers

Block late Na+ channels: reduces cardiomyocyte Ca2+ overload and myocyte tension

Ranolazine

Reduced MVO2 (myocardial volume oxygen consumption)

Ranolazine

May improve flow indirectly, reduces triggered activity: A fib and After depolarizations (V tach)

Ranolazine

Reduce the production of cholesterol in the liver, increase the clearance of LDL from the blood stream, also have anti inflammatory and plaque stabilizing actions

Statins