Pharmacology and therapeutic effects of nicorandil.

摘要: Nicorandil, a nicotinamide derivative, is an orally efficacious antianginal drug possessing nitrate moiety in its chemical structure. This effective and well-tolerated treatment for various types of angina pectoris. Its general efficacy similar to that nitrates, with several unique effects on the cardiovascular system. Nicorandil causes sustained dilation both arterial resistance conductive vessels, thus markedly dilating coronary artery increasing blood flow. In addition, nicorandil, unlike nitroglycerin or isosorbide dinitrate, possesses little hemodynamic effect heart rate, pressure, cardiac contractility clinical doses yielding effects. The mechanism causing vasodilation has not been completely clarified but appears be associated partly increases c-GMP, as well hyperpolarization smooth muscle membrane. single oral 10-30 mg, shown chronic stable angina, assessed objectively by exercise duration and/or time onset ST-segment depression during treadmill exercise. open studies controlled evaluations, nicorandil daily 15-40 mg demonstrated significant effectiveness Headaches due may occur, some side occurred 5.1-34% patients receiving were generally minor nature. There was no depressant atrioventricular conduction, which occurs frequently treated calcium antagonists verapamil diltiazem type. even rest effort who do respond combination therapy nitrates. Thus, valuable addition arsenal drugs low incidence serious