<prompt> Myocardial oxygen demand decreases by all EXCEPTDiltiazemMetoprololNitroglycerineAmrinone  <response>: Amrinone 507-KDT 6thAntianginal agents organic nitrates, b. Blockers, CCBs lowers the oxygen demand of the heart by affecting BP.Venous return. Heart rate and contractility 209-Lippncotts 4thDrugs that reduce cardiac size, rate or force reduces cardiac oxygen demand. Thus vasodilators, b blockers and calcium blockers have predictable benefits in angina 192-Katzung 11thDrug used in Angina Pectoris i Nitrates - nitroglycerin, Isosorbide dinitrate, Isosorbide mononitrateii Beta blockers - Propranolol, Atenolol, metoprolol iii Calcium channel blockers - Verapamil, Diltiazem, Nifedipineiv Miscellaneous - Ranolazine, IvabradineDILTIAZEM - CCBs 530-KDT 6th Direct depression of SA node and AV conduction Decrease HR.B.P Vasodilator - can relieve coronary artery spasm Modest negative inotropic actionMETOPROLOL - Cardio selective, class II anti arrhythmic drugs p-adrenergic antagonist Act by decreasing cardiac work and O2 consumption decreased HR, inotropic state and mean BP Depressing automaticity, contractility and prolonging AV conductionNITRATES 523- KDT6th 210- Lippincotts 4th These compounds cause a rapid reduction in myocardial oxygen demand-followed by rapid relief of symptoms Nitates decreases coronary vasoconstriction or spasm and increases perfusion of the myocardium by relaxing coronary arteries. In addition they relax veins, decreasing preload and myocardial oxygen consumption.AMRINONE Inamrinone - Phosphodiesterase III inhibits Positive inotropy and direct vasodilators It increases cardiac index, left ventricular ejection fraction and decreases peripheral vascular resistance. CVP. Left ventricular and diastolic volume and pressureCardiac O2 demand or O2 consumptionCorrelates with ventricular work per beatSo O2 demand a ventricular work per beat a stroke volume x mean arterial pressureCardiac O2 demand is determined primarily br - Intramyocardial tension, wall thickness, ventricular radius volume- Contractile site of the myocardium - Heart rateO2 consumption is 9ml100gmin by beating heart of rest increases with exercise various other states 