Introduction 42 year old Ramon Vasquez, went to see his cardiologist, Dr. Ramachandra Kolluru, in 1995. Mr. Vasquez was already a heart patient, and was seeing Dr. Kolluru for angina, or chest pain relating to coronary artery disease. The doctor wrote a prescription for 20 mg Isordil (isosorbide dinitrate) for angina, every six hours (Waters, 2000). The Drug Isordil is prescribed to relieve or prevent angina pectoris (suffocating chest pain). Angina pectoris occurs when the arteries and veins become constricted and sufficient oxygen does not reach the heart. Isordil dilates the blood vessels by relaxing the muscles in their walls. Oxygen flow improves as the vessels relax, and chest pain subsides. Isordil can cause severe low blood pressure, and patients with heart disease or low blood pressure should use this drug with caution. To prevent chronic stable angina pectoris, the usual starting dose for swallowed, immediately released Isordil is 5 to 20 milligrams. However, a doctor may increase this initial dose to 10 to 40 milligrams every 6 hours (Isordil, 2004). The Medical Er......

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