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Anti-Ischemic Drugs: Classification, Mechanism of Action, Uses and Side Effects

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Anti-ischemic drugs are used to prevent and treat myocardial ischemia by reducing cardiac oxygen demand or improving coronary blood flow. This topic explains the classification, mechanisms of action, therapeutic uses, and adverse effects of nitrates, beta blockers, calcium channel blockers, and newer antianginal agents, making it useful for pharmacy and medical students.

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December 20, 2025
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ADVANCE PHARMACOLOGY




Anti- Ischemic

, Ischemia

• Ischemia is a condition where there is reduced blood supply to a tissue, organ, or part of the b
• Ischemic heart disease refers to heart muscle weakening caused by reduced blood flow to the
heart.
• Because blood carries oxygen and nutrients, when blood flow decreases, the affected tissue ca
function properly.
• The cells are not getting enough oxygen because the blood flow is reduced.
• It usually occurs due to blockage or narrowing of blood vessels.
• Common causes:
Atherosclerosis (fat/plaque buildup in arteries)
Blood clots
Vasospasm (temporary narrowing of arteries)
Compression of blood vessels

, Type of Ischemia Organ Affected Example Condition
Myocardial ischemia Heart Angina, Heart attack
Cerebral ischemia Brain Stroke
Peripheral ischemia Limbs Peripheral artery disease



Angina Pectoris

Angina pectoris is a chest pain or discomfort caused by reduced blood flow and oxygen
supply to the heart muscle (myocardial ischemia) without causing permanent damage.

• Cause (Etiology)
Most commonly due to:
o Atherosclerosis of coronary arteries
o Coronary artery spasm
o Increased oxygen demand (exercise, stress)
o Reduced oxygen supply (anemia, hypotension)
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