Hey all, welcome back to the Real Life Pharmacology podcast. I'm your host Eric Christensen. Thank you so much for listening.

So always go check out real life pharmacology.com. Get your free 31 page PDF on the top 200 drugs.

Great resource. Absolutely no cost to you simply for subscribing via email to our email list. We'll get that sent to you.

So again, go check that out at no cost to you.

All right.

The drug of the day today is isosorbide mononitrate.

Brand name of this medication is Imder.

And you'll most often see this medication used on a chronic

basis for the prevention of angina symptoms. And indeed, that's exactly where I've seen it used in

clinical practice. How does this work? Well, it's a nitrate. So naturally it's going to form nitric oxide.

Nitric oxide activates guanolate cyclase, which increases cyclic gm p.

Ultimately, an increase in cyclic gm p causes smooth muscle relaxation and the long and the short of it is

we're going to get some vasodilation from that and imder isisorid mononitrate is more specific

for the veins versus the arteries.

It does have some action on the arteries as well, but it's going to have more action on the

veins.

So ultimately what this is going to do for the heart is reduce oxygen demand and reduce that preload because of that dilation of the veins.

So dosing, there is two dosage formulations of isosorbide mononitrate.

There is an immediate release formulation, which I can't say I've seen in quite some time.

Reason being is it requires twice daily dosing.

And the other unique thing, which I'll talk about with the tolerance factor, is you kind of got to dose that a little bit earlier in the day.

You're typically not going to do 8 a.m. and 8 p.m. probably with twice daily dosing.

...