| Appropriateness of nitrate use in a general medicine population. | |
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MedLine Citation:
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PMID: 11724079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Nitrates are one of the most commonly prescribed drug groups for cardiac disease, especially for angina pectoris and congestive heart failure. The chronic efficacy of nitrates is limited by the development of tolerance, which can be attenuated by use of sustained-release preparations or administration of regular-release preparations asymmetrically. OBJECTiVE: To determine whether patients receiving isosorbide 5-mononitrate (ISMN) use the drug in a pharmacologically appropriate manner and whether they had been instructed in the prophylactic use of sublingual nitrates prior to effort. METHODS: We administered a questionnaire regarding details of nitrate use to 229 patients with ischemic heart disease using oral ISMN, prescribed prior to their current admission. The study was conducted in a 600-bed university-affiliated hospital. RESULTS: We found that only 15% of patients receiving regular-release ISMN were taking the drug asymmetrically. In contrast, 82.6% of the patients receiving sustained-release ISMN were using the drug properly. Only 38.1% of the patients treated with regular-release ISMN were treated with the dose recommended in the literature. Furthermore, of the 190 patients who reported experiencing effort angina, only 17.9% had been instructed in the prophylactic use of nitrates prior to effort. CONCLUSIONS: The majority of patients (85%) using regular-release ISMN were taking the medication in an inappropriate fashion, while most patients taking sustained-release preparations were using them properly. More than half the patients treated with regular-release ISMN were treated with doses exceeding the recommended dose. In addition, most patients experiencing effort angina had not been instructed regarding the prophylactic use of nitrates. These findings suggest that both physicians and pharmacists must be reminded of the continuing need to properly counsel patients regarding appropriate drug use. |
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Authors:
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L Shilo; R Hadari; S Kovatz; M Qasim; L Shenkman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 35 ISSN: 1060-0280 ISO Abbreviation: Ann Pharmacother Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-28 Completed Date: 2002-04-08 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1339-42 Citation Subset: IM |
Affiliation:
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Department of Medicine C, Sapir Medical Center, Sackler School of Medicine, Tel Aviv University, Israel. lotansh@post.tau.ac.il |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Sublingual Aged Angina Pectoris / drug therapy Cardiovascular Agents / administration & dosage, therapeutic use* Drug Prescriptions Drug Utilization Review* Female Humans Male Middle Aged Myocardial Ischemia / drug therapy* Nitrates / administration & dosage, therapeutic use* Questionnaires |
| Chemical | |
Reg. No./Substance:
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0/Cardiovascular Agents; 0/Nitrates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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