A client with Variant (Prinzmetal’s) Angina is likely to be prescribed which class of medication?

Variant (Prinzmetal's) angina is caused by coronary artery vasospasm rather than fixed atherosclerotic obstruction, so the primary pharmacological goal is vasodilation and spasm prevention. Calcium channel blockers — particularly non-dihydropyridines such as diltiazem and verapamil, as well as dihydropyridines like amlodipine — are first-line therapy because they inhibit calcium-mediated smooth muscle contraction in coronary vessels, directly relieving and preventing spasm. Beta-blockers are generally avoided in Prinzmetal's angina because blocking beta-2 receptors can leave alpha-adrenergic vasoconstriction unopposed, potentially worsening coronary spasm. Aspirin is appropriate for platelet inhibition in typical atherosclerotic angina and acute coronary syndrome but does not address the vasospastic mechanism of Prinzmetal's angina. Loop diuretics reduce preload and are used in heart failure and hypertension management but have no role in preventing coronary vasospasm. Recognizing that the pathophysiology — not just the symptom — determines drug selection is the key principle here, and that principle consistently distinguishes Prinzmetal's management from typical stable angina management on nursing exams.