MOA: Primarily vasodilators that dilate, veins, arterioles, and particularly the coronary arteries by relaxing vascular smooth muscle cells, but also venodilators
Their primary anti-ischemic effects are due to systemic vasodilation and decreasing cardiac preload (lowering LVEDV and LVESV) rather than coronary vasodilation
This causes reduced LV wall stress reducing myocardial oxygen demand, and relieving anginal symptoms
Arterial and arteriolar vasodilation can decrease SVR and blood pressure, but to a lesser degree
They do act as coronary vasodilators, but benefit is uncertain
No direct effect on cardiac chronotropy, inotropy (contractility), LVEF
USE: Chest pain relief in patients with chronic stable angina and ACS
SE: Reflex Tachycardia
Concomitant use of beta-blockers to prevent
Isosorbide Dinitrate
USE:
FDA Approved: Prevention or treatment (glyceryl trinitrate preferred) of angina pectoris from CAD
Non-FDA Approved: Achalasia, DES
Isosorbide Mononitrate
USE:
FDA Approved: Treatment of angina pectoris from CAD