OBAT ANTI ANGINA

dr. Ilham Hariaji,MBiomed

Departemen Farmakologi dan Terapi

Fakultas Kedokteran
Universitas Muhammadiyah Sumatera Utara
 Patofisiolgi

Iskemia miokard

Ketidak seimbangan antara suplay oksigen dan

kebutuhan oksigen jantung
Atherosclerosis Process
 Fisiologi

Frekwensi denyut
jantung

Tegangan dinding
Oksigen Deman ventrikel kiri( tek darah
sistemik)

Kontraktillitas miokard (
pengaruh adrenoseptor,
kanal Ca)
 Fisiologi
Frek. Denyut Jantung
(lama diastol)

Kapasitas Angkut
Oksigen suplay Oksigen oleh sel darah
merah)

Kelainan pembuluh
koroner
 Terapi Angina

AKUT

M = Morfin
O = Oxigen
N = Nitrat
A = Aspirin
Co = Clopidogrel
 NITRATES
CONTRAINDICATIONS
Previous hypersensitivity
Hypotension ( < 80 mmHg)
AMI with low ventricular filling pressure
1st trimester of pregnancy

WITH CAUTION:
ž Constrictive pericarditis
ž Intracranial hypertension
ž Hypertrophic cardiomyopathy
ß-ADRENERGIC BLOCKERS
CONTRAINDICATIONS
Hypotension: BP < 100 mmHg
Bradycardia: HR < 50 bpm
Chronic bronchitis, ASTHMA
Severe chronic renal insufficiency
 Reasons for Using Nitrates and Beta Blockers in
Combination in Angina
• Beta Blockers prevent reflex tachycardia and contractility
produced by nitrate-induced hypotension.
• Nitrates prevent any coronary vasospasm produced by Beta
Blockers.
• Nitrates prevent increases in left ventricular filling pressure or
preload resulting from the negative inotropic effects produced
by Beta Blockers.
• Nitrates and Beta Blockers both reduce myocardial oxygen
consumption by different mechanisms.
• Nitrates and Beta Blockers both increase subendocardial
blood flow by different mechanisms
 Simpulan
• Angina pektoris terjadi akibat adanya
keseimbangan antara oksigen suplay dan
oksigen deman pada pembuluh jantung
sehingga mempengaruhi otot jantung
• Tujuan terapi angia pektoris adalah
mengupayakan keseimbangan oksigen suplay
dan deman pada otot jantung sehingga
iskemia otot jantung dapat diatasi dan infark
miokard dapat diatasi
 Daftar Pustaka
• Buku farmakologi FK UI
• http://medvin2u.net/wp-
content/uploads/2014/02/angina-pectoris-a.jpg
• http://i2.wp.com/www.heartupdate.com/wp-
content/uploads/2014/04/angina-pectoris-pain-
irradiation.jpg
• http://img.medscape.com/slide/migrated/editorial/cm
ecircle/2006/6092/images/presentation/slide003.gif
• https://edc2.healthtap.com/ht-
staging/user_answer/avatars/710705/large/open-
uri20130828-29723-yx5ejp.jpeg?1386566776
 dr. Ilham Hariaji, MBiomed

Departemen Farmakologi dan Terapi

Fakultas Kedokteran
Universitas Muhammadiyah Sumatera Utara

dr.Ilham Hariaji M,Biomed (FK UMSU)

40
Maret 2016