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(However, in pharmacological experiments on isolated cardiac muscle preparations a clear negative inotropic effect is demonstrable.) They are thus regarded as vasoselective Ca2+ antagonists. Because of the dilatation of resistance vessels, blood pressure falls. Cardiac afterload is diminished and, therefore, also oxygen demand. Spasms of coronary arteries are prevented.
Transdermal delivery (nitroglycerin patch) also avoids presystemic elimination. Isosorbide dinitrate (ISDN) penetrates well through membranes, is more stable than NTG, and is partly degraded into the weaker, but much longer acting, 5- isosorbide mononitrate (ISMN). ISDN can also be applied sublingually; however, it is mainly administered orally in order to achieve a prolonged effect.


Inhibition of the enzyme causes free NE concentrations to rise. Likewise, dopamine catabolism is impaired, making more of it available for NE synthesis. Consequently, the amount of NE stored in granular vesicles will increase, and with it the amount of amine released per nerve impulse. In the CNS, inhibition of MAO affects neuronal storage not only of NE but also of dopamine and serotonin.
As shown by the binding curves (dashed lines), this can still be achieved with a reduced receptor number, although only at a higher concentration of insulin. Development of adult diabetes (B). Compared with a normal subject, the obese subject requires a continually elevated output of insulin (orange curves) to avoid an excessive rise of blood glucose levels (green curves) during a glucose load.


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