Combination therapy involving intravenous nitrates, calcium antagonists, p-blockade and heparinisation has been shown to be beneficial in unstable angina; thrombolytic therapy confers no added advantage.

Potassium channel openers belong to a new class of drug yet to be extensively evaluated in critically ill patients and should be thus used with caution, especially when hyperkalaemia is a concern.

Angina may occasionally be worsened by a 'coronary steal' phenomenon where blood flow is diverted away from stenosed coronary vessels. This does not, however, occur with nicorandil.


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