{"id":10173,"date":"2012-04-22T09:28:13","date_gmt":"2012-04-22T09:28:13","guid":{"rendered":"http:\/\/cardiophile.org\/?p=6966"},"modified":"2023-08-09T15:20:24","modified_gmt":"2023-08-09T09:50:24","slug":"mechanism-of-action-of-newer-anti-anginal-drugs-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/mechanism-of-action-of-newer-anti-anginal-drugs-2\/","title":{"rendered":"Mechanism of action of ranolazine, trimetazidine and nicorandil"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/fCBUJvlLK7k\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Mechanism of action of ranolazine, trimetazidine and nicorandil<\/span><\/h2>\n<p>Conventional mainstay of anti anginal therapy are beta blockers, nitrates and calcium channel blockers. They mostly decrease myocardial oxygen demand with little effect on the myocardial oxygen supply or utilization. Even for nitrates, the predominant effect is venodilatation and reduction of preload and hence the myocardial oxygen demand rather than coronary vasodilatation and increase in supply. Hence the maximum rate pressure product achieved, the determinant of peak myocardial oxygen demand, is seldom altered.<\/p>\n<p><strong>Ranolazine <\/strong>inhibits the late sodium current and hence the calcium influx into the ischemic myocardium. This reduces myocardial diastolic wall tension and enhances blood flow into the ischemic myocardium, which is predominantly diastolic.<\/p>\n<p><strong>Trimetazidine<\/strong> inhibits beta oxidation of fatty acids partially and shifts the myocardial metabolism towards glucose which utilizes less oxygen per ATP produced.<\/p>\n<p><strong>Nicorandil<\/strong> on the other hand induces pharmacological preconditioning akin to ischemic preconditioning as well as produces dilatation of coronary resistance vessels.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Newer anti anginal drugs: ranolazine inhibits late sodium current, trimetazidine inhibits beta oxidation of fatty acids, nicorandil dilates coronary resistance vessels.<\/p>\n","protected":false},"author":1,"featured_media":60464,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-10173","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Mechanism of action of newer anti anginal drugs<\/title>\n<meta name=\"description\" content=\"Newer anti anginal drugs: ranolazine inhibits late sodium current, trimetazidine inhibits beta oxidation of fatty acids, nicorandil dilates coronary resistance vessels.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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