Document Detail

Age-related changes in the pharmacodynamics of intravenous glyceryl trinitrate.
MedLine Citation:
PMID:  2128809     Owner:  NLM     Status:  MEDLINE    
Comparable hemodynamic effects were obtained administering a much lower intravenous dose of glyceryl trinitrate (GTN) in elderly than in younger patients. The pharmacodynamics and kinetics of GTN were thus assessed in 2 groups of patients with acute myocardial infarction (group A: less than or equal to 65 years, 6 patients; group B: greater than or equal to 75 years, 6 patients). The arterial and venous dose-concentration relationship and the associated hemodynamic changes at end-point (EP: 10% reduction in mean systemic arterial pressure) were similar in the 2 groups. However, in older subjects EP was reached at a lower GTN infusion rate (0.11 +/- 0.04 vs 0.33 +/- 0.11, mean +/- S.D.; p less than 0.001), and with lower arterial and venous drug concentrations (arterial [GTN]: 1.2 +/- 0.1 vs 4.6 +/- 1.2; p less than 0.01; venous [GTN]; 0.09 +/- 0.05 vs 0.35 +/- 0.15; p less than 0.05), whereas overall GTN kinetics appeared to be substantially independent of age. Thus, the enhanced efficacy of GTN in advanced age seems to stem mainly from pharmacodynamic changes, which may be the consequence of dampened baroreceptor reflexes, as suggested by a lower heart rate increase per unitary fall in systolic arterial pressure observed in group B (0.12 +/- 0.07 vs 0.41 +/- 0.29 b.min-1.mmHg-1; p less than 0.05).
N Marchionni; L Ferrucci; S Fumagalli; L Boncinelli; B Salani; M Di Bari; G Moschi; M Paoletti; C Bürgisser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aging (Milan, Italy)     Volume:  2     ISSN:  0394-9532     ISO Abbreviation:  Aging (Milano)     Publication Date:  1990 Mar 
Date Detail:
Created Date:  1991-07-03     Completed Date:  1991-07-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102503     Medline TA:  Aging (Milano)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  IM    
Department of Gerontology, University of Florence, Italy.
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MeSH Terms
Aging / physiology*
Hemodynamics / drug effects
Injections, Intravenous
Middle Aged
Nitroglycerin / blood,  pharmacokinetics,  pharmacology*
Reg. No./Substance:

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