PHARMACOLOGY OF ISOSORBIDE MONONITRATE
INTRODUCTION
Isosorbide mononitrate is a drug used principally in the treatment of angina pectoris and acts by dilating the blood vessels so as to reduce blood pressure.
MECHANISM OF ACTION
Isosorbide mononitrate is converted to nitric acid, an active intermediate compound which activates the enzyme guanylate cyclase. This stimulates the synthesis of cyclic guanosine 3,5-monophosphate which then activates a series of protein kinase dependent phosphorylation of the smooth muscle fiber .The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.
USES
Isosorbide mononitrate is a nitrate class drug used for the prophylactic treatment of angina pectoris that is it is taken in order to prevent or at least to reduce the occurrence of angina .
SIDE EFFECTS
1. Abnormal heart sound
2. Arm, back, or jaw pain
3. Burning while urinating
4. Chest tightness or heaviness
5. Weight gain
6. Convulsions
7. Chest pain or discomfort
8. Bleeding gums
9. Blood in urine and stools
10. Blurred vision
DRUG DRUG INTERACTION
1. Isosorbide mononitrate +sildenafil = potentiate vasodilatory effect of isosorbide mononitrate
2. Isosorbide mononitrate + verapamil = improve left ventricular functional parameters
3. Isosorbide mononitrate + propranolol = reduction in hepatic blood flow
4. Isosorbide mononitrate + sulfhydryl containing compounds = prolong total exercise time in patient with angina pectoris
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