PCOL2605 Lecture Notes - Lecture 19: Isosorbide Mononitrate, Isosorbide Dinitrate, Cyclic Guanosine Monophosphate

• School: University of Sydney
• Department: Pharmacology
• Course: PCOL2605
• Professor: Brooke Storey Lewis

Document Summary

11/9/18: a(cid:374)gi(cid:374)a o(cid:272)(cid:272)u(cid:396)s (cid:449)he(cid:374) the (cid:373)(cid:455)o(cid:272)a(cid:396)dial o(cid:454)(cid:455)ge(cid:374) de(cid:373)a(cid:374)d e(cid:454)(cid:272)eeds suppl(cid:455) - myocardial ischaemia, a(cid:374)gi(cid:374)a i(cid:374)(cid:272)ludes: Variant (printzmetal) angina (coronary spasm: a(cid:272)ute (cid:272)o(cid:396)o(cid:374)a(cid:396)(cid:455) s(cid:455)(cid:374)d(cid:396)o(cid:373)e (cid:894)acs(cid:895) Beta adrenoceptor blocking agents (beta blockers: t(cid:396)eat(cid:373)e(cid:374)t of u(cid:374)de(cid:396)l(cid:455)i(cid:374)g (cid:272)o(cid:374)ditio(cid:374)s. Cause venous dilation which reduces venous return and preload, and reduces cardiac work and oxygen demand. Reduced conversion of nitrate to nitric oxide - depletion of sulfhydryl (sh) groups. Isosorbide dinitrate: p(cid:396)oph(cid:455)la(cid:272)ti(cid:272) t(cid:396)eat(cid:373)e(cid:374)t - glyceryl trinitrate. Isosorbide mononitrate - isosorbide dinitrate: ca(cid:374) also (cid:271)e used i(cid:374) the (cid:373)a(cid:374)age(cid:373)e(cid:374)t of hea(cid:396)t failu(cid:396)e (cid:894)(cid:396)edu(cid:272)tio(cid:374) i(cid:374) p(cid:396)eload a(cid:374)d afte(cid:396)load(cid:895) Cause artery/arteriolar dilation which reduces peripheral resistance and afterload, and reduces cardiac work and oxygen demand. Dilate coronary vessels and increase coronary blood flow which increases the oxygen supply to the heart muscle. Do not affect veins or preload: those used i(cid:374) the t(cid:396)eat(cid:373)e(cid:374)t of a(cid:374)gi(cid:374)a i(cid:374)(cid:272)lude. Does not respond to diuretics: co(cid:374)stipatio(cid:374) e. g. (cid:448)e(cid:396)apa(cid:373)il, d(cid:396)ug i(cid:374)te(cid:396)a(cid:272)tio(cid:374)s.