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Decrease in nitric oxide
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Increase in cAMP
Increase in cGMP
Increase in phosphodiesterase
Net actin polymerization
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Nitroglycerin's mechanism of action involves an increase in intracellular cGMP levels which promotes vasodilation of the vasculature. Nitrates are converted to nitric oxide at the vascular smooth muscle cell membrane. Within vascular smooth muscle cells, NO stimulates guanylyl cyclase to convert GTP into cGMP, which mediates decreases in intracellular calcium and subsequent myosin dephosphorylation. Smooth muscle relaxation and venodilation result. 1) Nitrates ultimately lead to an increase in nitric oxide. 2) Nitrates affect cGMP levels, not cAMP levels 4) Nitroglycerin has no affect on phosphodiesterase levels. It only increases the amount of cGMP within the cell. 5) Nitrates have no affect on net actin polymerization. Nitrates are used to cause venodilation via increasing intracellular cGMP levels.
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