Isosorbide Mononitrate Flashcards
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Questions and Answers

What is the brand name of Isosorbide Mononitrate?

Imdur

What is the drug class of Isosorbide Mononitrate?

Antianginal

What are the routes of administration of Isosorbide Mononitrate?

Oral Tablet, Extended Release: 30 mg, 60 mg, 120 mg; Oral Tablet, Immediate Release: 10 mg, 20 mg

What are the common indications and dosing of Isosorbide Mononitrate?

<p>Angina, prophylaxis: Adults, extended release, initial, 30-60 mg po daily, may titrate to maintenance of 120-240 mg po daily; immediate release, 20 mg po bid separated 7 h apart to decrease tolerance development</p> Signup and view all the answers

What is the mechanism of action of Isosorbide Mononitrate?

<p>Active 5-mononitrate metabolite of isosorbide dinitrate. Nitroglycerin and other organic nitrates are converted to nitric oxide (NO) by vascular endothelium. NO activates guanylate cyclase, increasing cyclic GMP, which in turn decreases intracellular calcium, resulting in direct relaxation of vascular smooth muscle.</p> Signup and view all the answers

What is the dose adjustment renal for Isosorbide Mononitrate?

<p>NONE</p> Signup and view all the answers

Are there pharmacogenetics for Isosorbide Mononitrate?

<p>NONE</p> Signup and view all the answers

What are the contraindications to Isosorbide Mononitrate?

<p>Hypersensitivity to nitrates, concurrent use with PDEIs, concurrent use with riociguat</p> Signup and view all the answers

What are the black box warnings for Isosorbide Mononitrate?

<p>NONE</p> Signup and view all the answers

What are the drug interactions with Isosorbide Mononitrate?

<p>CYP3A4/5 inducers, CYP3A4/5 inhibitors, phosphodiesterase inhibitors (erectile dysfunction medications) (CONTRAINDICATED), riociguat (CONTRAINDICATED)</p> Signup and view all the answers

What are the common adverse reactions with Isosorbide Mononitrate?

<p>Dizziness, headache</p> Signup and view all the answers

What are rare but serious adverse reactions with Isosorbide Mononitrate?

<p>Severe hypotension, syncope</p> Signup and view all the answers

What are the efficacy monitoring parameters for Isosorbide Mononitrate?

<p>Decreased use of sublingual nitroglycerin, reduction in angina episodes.</p> Signup and view all the answers

What are the toxicity monitoring parameters for Isosorbide Mononitrate?

<p>Report signs/symptoms of hypotension, problematic headaches, or decreasing efficacy (drug tolerance) to prescriber</p> Signup and view all the answers

Study Notes

Brand Name

  • Isosorbide Mononitrate is marketed under the brand name Imdur.

Drug Class

  • Classified as an antianginal medication.

Routes of Administration

  • Available as oral tablet forms:
    • Extended Release: 30 mg, 60 mg, 120 mg
    • Immediate Release: 10 mg, 20 mg.

Common Indications and Dosing

  • Primarily prescribed for angina prophylaxis in adults.
  • Initial dosing for extended release: 30-60 mg orally once daily, can titrate to 120-240 mg for maintenance.
  • Immediate release dosing: 20 mg taken orally twice daily, spaced 7 hours apart to limit tolerance.

Mechanism of Action

  • Functions as the active 5-mononitrate metabolite of isosorbide dinitrate.
  • Converts to nitric oxide (NO) in vascular endothelium, activating guanylate cyclase.
  • Increases cyclic GMP, decreases intracellular calcium, leading to relaxation of vascular smooth muscle.

Renal Dose Adjustment

  • No dose adjustments required for patients with renal impairment.

Pharmacogenetics

  • No notable pharmacogenetic factors affect the use of Isosorbide Mononitrate.

Contraindications

  • Contraindicated in patients with hypersensitivity to nitrates.
  • Should not be used concurrently with phosphodiesterase inhibitors (PDEIs) or riociguat.

Black Box Warnings

  • There are no black box warnings for Isosorbide Mononitrate.

Drug Interactions

  • Interactions may occur with CYP3A4/5 inducers and inhibitors.
  • Strong contraindications with PDE inhibitors and riociguat, particularly for erectile dysfunction treatments.

Common Adverse Reactions

  • Frequently reported side effects include dizziness and headache.

Rare but Serious Adverse Reactions

  • Severe hypotension and syncope are rare but serious potential side effects.

Efficacy Monitoring Parameters

  • Effectiveness can be monitored by a decrease in the use of sublingual nitroglycerin and reduction in angina frequency.

Toxicity Monitoring Parameters

  • Patients should report signs of hypotension, severe headaches, or any decrease in drug efficacy to their healthcare provider.

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Description

Test your knowledge about Isosorbide Mononitrate with these flashcards. Covering brand names, drug class, routes of administration, and common indications, this quiz helps reinforce your understanding of this important medication. Perfect for pharmacy students and healthcare professionals alike.

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