Isosorbide Dinitrate

• Mechanism of Action
• Converted to nitrous oxide which stimulates vascular smooth muscle relaxation through stimulation of cGMP-dependant protein kinase with resultant reduction in intracellular calcium.
  Results in venous dilatation (reduced preload), arterial dilatation (reduced afterload) and coronary dilatation (improved myocardial oxygen supply)

Clinical Use

• • Indications
  • Stable angina pectoris
  • Heart failure – especially in the setting of hypertension or MI
• • Adverse Effects
  • Flushing
  • Headache / dizziness
  • Nausea / vomiting
  • Postural hypotension / tachycardia / syncope