The Sound of Evolution
Isosorbide dinitrate
Mechanism of action:
Isosorbide dinitrate is an organic nitrate vasodilator. After entering the body, it is metabolized into isosorbide mononitrate and is further converted enzymatically within vascular smooth muscle to release nitric oxide (NO). Nitric oxide stimulates soluble guanylate cyclase, increasing cGMP levels. cGMP promotes dephosphorylation of myosin light chains and reduces the effect of calcium on contractile proteins, leading to relaxation of vascular smooth muscle. This causes venous dilation, reduces venous return, lowers ventricular wall tension, and decreases myocardial oxygen demand.
Reference(s):
1. Villarroya M et al. (2005). Preclinical profile of PF9404C, a nitric oxide donor with beta receptor blocking properties. Cardiovasc Drug Rev.
2. Takabuchi S et al. (2004). The inhibitory effect of sodium nitroprusside on HIF-1 activation is not dependent on nitric oxide–soluble guanylyl cyclase pathway. Biochem Biophys Res Commun.