Document Detail

Comparison of buccal nitroglycerin and oral isosorbide dinitrate for nitrate tolerance in stable angina pectoris.
MedLine Citation:
PMID:  3933317     Owner:  NLM     Status:  MEDLINE    
Sixteen patients with chronic stable angina pectoris were studied to compare the hemodynamic and antianginal effects of buccal nitroglycerin (GTN) in a dose of 3 mg administered 3 times daily and oral isosorbide dinitrate (ISDN) in a dose of 30 mg administered 4 times daily. Compared with placebo, both oral ISDN and buccal GTN treatment induced a decrease in systolic blood pressure at rest over a 5-hour period during acute but not during sustained therapy. Neither buccal GTN nor oral ISDN modified the changes in systolic blood pressure during exercise. Both treatment programs were associated with a higher exercise heart rate during acute therapy. During sustained treatment with buccal GTN, the heart rate during exercise remained greater than that during placebo throughout the 5-hour test period, but during treatment with oral ISDN, only the exercise heart rate at 1 hour was greater than that seen with placebo. Treadmill walking time to the onset of angina and to the development of moderate angina increased significantly during acute therapy with both buccal GTN and oral ISDN. The clinical efficacy of buccal GTN was maintained after 2 weeks of 3-times-daily therapy. In contrast, during 4-times-daily therapy with oral ISDN, treadmill walking time was prolonged for only 1 hour after drug administration. This investigation indicates that tolerance develops during 4-times-daily therapy with oral ISDN, but 3 times daily therapy with buccal GTN is not associated with diminished antianginal effects.
J O Parker; K A Vankoughnett; B Farrell
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  56     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1985 Nov 
Date Detail:
Created Date:  1985-11-25     Completed Date:  1985-11-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  724-8     Citation Subset:  AIM; IM    
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MeSH Terms
Angina Pectoris / drug therapy*
Drug Therapy, Combination
Drug Tolerance
Hemodynamics / drug effects
Isosorbide / administration & dosage,  therapeutic use*
Middle Aged
Nitroglycerin / administration & dosage,  therapeutic use*
Physical Exertion
Sorbitol / analogs & derivatives*
Reg. No./Substance:
50-70-4/Sorbitol; 55-63-0/Nitroglycerin; 652-67-5/Isosorbide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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