title: Calcium antagonists.
abstract: At present nitrates remain the initial treatment for relief or prevention of angina in patients with coronary artery disease. In cases where nitrates and beta blockers have been used and are ineffective for managing effort angina, calcium antagonists may be substituted or added to the beta-blocking treatment. When the predominant symptom is rest angina, and there is evidence suggesting coronary artery spasm, nitrates and a calcium antagonist can be effective therapy. In patients with heart block, bradyarrhythmias, heart failure, or hypertension nifedipine may be the drug of choice. In contrast verapamil merits choice when supraventricular tachycardia is present. Diltiazem appears intermediate between nifedipine and verapamil and may be particularly useful when hypotension or other side effects must be avoided.
authors.forename: C R
authors.initials: CR
authors.lastname: Conti
authors.forename: C J
authors.initials: CJ
authors.lastname: Pepine
authors.forename: R L
authors.initials: RL
authors.lastname: Feldman
authors.forename: J A
authors.initials: JA
authors.lastname: Hill
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000787:Angina Pectoris / Q000188:drug therapy*; D002118:Calcium / Q000502:physiology*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000188:drug therapy*; D003329:Coronary Vasospasm / Q000188:drug therapy; D004110:Diltiazem / Q000378:metabolism / Q000494:pharmacology; D006321:Heart / Q000502:physiology*; D006801:Humans; D009119:Muscle Contraction / Q000187:drug effects; D009131:Muscle, Smooth, Vascular / Q000502:physiology; D009200:Myocardial Contraction / Q000187:drug effects; D009543:Nifedipine / Q000378:metabolism / Q000494:pharmacology; D009566:Nitrates / Q000494:pharmacology; D010101:Oxygen Consumption / Q000187:drug effects; D013997:Time Factors; D014700:Verapamil / Q000378:metabolism / Q000494:pharmacology
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009566:Nitrates; D014700:Verapamil; D004110:Diltiazem; D009543:Nifedipine; D002118:Calcium