A patient having prinzmetal angina is started with ISMN. Patient got symptomatic relief from angina. What is the MOA?
ANS. A# Important points on nitrates1. All nitrates have high FPM metabolism except ISMN (Isosorbide mononitrate)2. Skin rashes are maximum with Pentaerythritol tetranitrate3. Nitrates used in acute attack: NTG and ISDN (Isosorbide dinitrite)
Endothelium independent coronary vasodilatation
Reduced cardiac contractility
Increased left ventricular end diastolic volume
Decreased diastolic perfusion pressure
C.V.S