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Nitrates (dosage forms (ORAL (ISDN and NTG = extensive first pass…
Nitrates
dosage forms
ORAL
ISDN and NTG = extensive first pass metabolism; EXCEPT Mononitrate is completely bioavailable and longer half-life
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effects on MVO2
Venous vasodilation
decrease blood return to heart (preload) = decrease LV volume, wall stress, oxygen demand
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:forbidden: CI
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vasodilator effects of nitrates are profoundly HTN amplified with 25 mmHg drop in SBP --> hemodynamic instability and potentially fatal events
MOA
vasodilation - nitroprusside and nitrates induce vasorelxation via the formation of NO and subsequent activation of guanylate cyclase and generation of cGMP
effects on oxygen supply
dilate large epicardial coronary a. and collateral vessels in areas of stenosis = increase oxygen supply
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