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It is converted to nitric oxide (NO), that activates guanylate cyclase that in turn stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) that also in turn activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, that leads to dephosphorylation of the myosin light chain of the smooth muscle releasing calcium ions results in the relaxation of the smooth muscle cells and vasodilation.
Malnutrition, renal / hepatic im- pairment, hypothyroidism, development of toler- ance, glaucoma, headache, hypotension, to be withdrawn gradually
allergy to nitrates, closed angle glaucoma, head trauma, hypotension, severe anaemia, allergy to adhesives. Cardia temponade, pregnancy
Throbbing headache, mental disturbances, insomnia, nausea and vomiting, flushing, postural hypotension, tachycardia, impotence, dysuria, involuntary passing of urine and stool