A patient having prinzmetal angina is started with ISMN. Patient got symptomatic relief from angina. What is the MOA?: (A) Endothelium independent coronary vasodilatation, (B) Reduced cardiac contractility, (C) Increased left ventricular end diastolic volume, (D) Decreased diastolic perfusion pressure
Answer is A. ANS. A# Important points on nitrates1. All nitrates have high FPM metabolism except ISMN (Isosorbide mononitrate)2. Skin rashes are maximum with Pentaerythritol tetranitrate3. Nitrates used in acute attack: NTG and ISDN (Isosorbide dinitrite)