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MECHANISM OF ACTION Nicorandil acts by relaxing the smooth muscle of the blood vessels, especially those of the venous system. It does this through t…
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MECHANISM OF ACTION Nicorandil acts by relaxing the smooth muscle of the blood vessels, especially those of the venous system. It does this through two methods. Firstly, by activating potassium channels, and secondly by donating nitric oxide to activate the enzyme guanylate cyclase. Guanylate cyclase causes activation of GMP leading to both arterial and venous vasodilatation. As it is selective for vascular potassium channels, it has no significant action on cardiac contractility and conduction. Although it can dilate the coronary vessels of a healthy individual, its effects on the coronary vessels of someone with ischemic heart disease will be little as they will already be completely dilated. Instead, it dilates the venous system, reducing preload and the work of the heart
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