Nitrosamines can be formed through various chemical processes, including the reaction between nitrites and secondary amines in certain conditions. It is a N-Nitroso of secondary amine present in Perhexiline. Nitrosamines are part of a broader class of compounds known as N-nitroso compounds. Perhexiline is a medication primarily used in the treatment of angina, a condition characterized by chest pain or discomfort due to reduced blood flow to the heart muscles. It belongs to the class of drugs known as antianginals. Perhexiline is unique in that it exhibits antianginal effects through its modulation of myocardial metabolism rather than by increasing blood flow. Specifically, it inhibits the mitochondrial enzyme carnitine palmitoyltransferase-1 (CPT-1), leading to a shift in cardiac energy metabolism from fatty acids to glucose. This metabolic alteration improves myocardial efficiency and reduces oxygen demand.
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