Nicorandil is used in stable angina pectoris. Its dual mechanism of action involves:
- A Nitrate-like NO donation AND potassium channel (KATP) opening in vascular smooth muscle ✓
- B Selective inhibition of late sodium current AND L-type calcium channel blockade
- C Beta-1 blockade AND nitrate-like coronary vasodilation
- D Ivabradine-like heart rate reduction AND direct vasodilation via phosphodiesterase inhibition
Correct answer: A. Nitrate-like NO donation AND potassium channel (KATP) opening in vascular smooth muscle
Explanation
Nicorandil is a nicotinamide nitrate ester with dual action: its nitrate moiety releases NO, activating guanylyl cyclase and reducing preload (venous dilation); its KATP channel-opening action hyperpolarises vascular smooth muscle, causing arterial vasodilation and reducing afterload. This combination dilates both veins and coronary arteries (including resistant and epicardial vessels). Option B describes ranolazine; option C describes carvedilol/nitrates combination; option D is not a single drug.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.