Medicines Isosorbide dinitrate

The double dehydration of sorbitol yields D-isosorbide (l,4 3,6-dianhydrohexitol), a white, biodegradable, nontoxic solid. It is used in medicine to treat glaucoma. Other medications are derived from isosorbide, including isosorbide dinitrate and isosorbide mononitrate used to treat angina pectoris. The high thermal stability makes isosorbide interesting as a monomeric building block for thermoplastic polymers such as polyester and polycarbonates. The electrophilic alkylation of isosorbide with dimethyl sulfate yields dimethyl isosorbide, a colorless liquid which is used as a plasticizer for vinyl polymers and as a solvent in pharmaceutical and cosmetic preparations. 

Some nitrate esters are widely used in medicine as coronary vasodilators. Gas chromatography-mass spectrometry was often used to determine these nitrate esters and their metabolites in human plasma. Nitroglycerin and its two metabolites, glycerol-1,2-dinitrate and glycerol 1,3-dinitrate, were most frequently analyzed in human plasma. Other pharmaceutically employed nitrate esters, such as isosorbide dinitrate and PETN, were also determined in blood by GC-MS. The preferred ionization method for the determination of these nitrate esters in blood was NCI in the SIM mode, often monitoring the NOs" at m/z 62. The analytical procedures are not discussed here but are reviewed in detail elsewhere [20]. 

The hexitol anhydrides also have medicinal uses.97 Carr and Krantz98 found that l,4 3,6-dianhydro-D-mannitol was quite non-toxic to man and was a valuable diuretic. The dinitrates of both isomannide and isosorbide" have possible uses as agents for lowering blood pressure, though Burn and Stephenson100 found that the D-sorbitol derivative was twice as active as the D-mannitol derivative in this respect. 2,5-Diam-ino-2,5-didesoxy-l,4 3,6-dianhydro-D-mannitol and -D-sorbitol have been prepared and their sulfanilamido derivatives obtained.101 These however showed no outstanding bacteriostatic activity. 

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