Paper I
2017 August (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Mechanism of action of nitrates.

Q101 marksShort Answers

Answer

Nitrates release nitric oxide (NO), which activates guanylyl cyclase in vascular smooth muscle, increasing intracellular cGMP. This causes dephosphorylation of myosin light chains, leading to smooth muscle relaxation — predominantly venodilatation (reducing preload) with some arteriolar dilatation (reducing afterload), along with coronary vasodilatation, which together reduce myocardial oxygen demand and relieve anginal pain.

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