Angina is an oxygen supply-and-demand problem, and every antianginal lowers demand (heart rate, contractility, wall tension), raises supply, or both. Beta blockers are first line. Calcium channel blockers split into the heart-acting non-dihydropyridines and the vessel-acting dihydropyridines. Nitrates relieve the acute attack and are adjuncts over the long term, limited by tolerance and by the phosphodiesterase-5 inhibitor interaction. What these do and do not ask. Indications, adverse effects, contraindications and patient education are in, weighted above mechanism. Doses are out (the aspirin chew dose, the ointment measure and tablet strengths), and so are trial percentages, which is why the sets run shorter than the usual 30. Every option carries its own reason, correct and incorrect alike.
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