Document Detail


Intravenous glyceryl trinitrate (nitroglycerin). A review of its pharmacological properties and therapeutic efficacy.
MedLine Citation:
PMID:  6420139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The recently introduced preparation of intravenous glyceryl trinitrate (nitroglycerin) provides a rapid steady therapeutic blood concentration of nitrates during continuous infusion. Intravenous glyceryl trinitrate causes venodilation at low doses, but at higher doses dilates both arteries and veins. Its principal haemodynamic effects at therapeutic dosages include a decrease in blood pressure in preload (left ventricular filling pressure) and in determinants of afterload, and a decrease in myocardial oxygen demand. Human pharmacokinetic data are few and difficult to interpret due to wide interstudy and interindividual variation. There is no close correlation between infusion rate, blood concentration and haemodynamic effects. The nature of the patient population treated with intravenous glyceryl trinitrate has largely precluded the use of a placebo, but in open trials the drug has been used successfully in the treatment of unstable angina, left ventricular failure accompanying acute myocardial infarction and in the control of hypertension associated with cardiac surgery at dosages titrated to achieve a specific end-point. Favourable haemodynamic responses have been achieved in very short term studies in congestive heart failure, and preliminary studies suggest that institution of intravenous glyceryl trinitrate early after acute myocardial infarction may limit ischaemic damage. However, use of the drug in acute myocardial infarction remains controversial. Intravenous glyceryl trinitrate is generally well tolerated, although hypotension and headache occur occasionally, and sinus tachycardia and bradycardia less frequently. Careful titration of dosage is required (beginning at 5 micrograms/min), and if the infusion sets contain polyvinylchloride, the delivered dose is lower than that calculated, because of adsorption of glyceryl trinitrate onto the plastic tubing.
Authors:
E M Sorkin; R N Brogden; J A Romankiewicz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Drugs     Volume:  27     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  1984 Jan 
Date Detail:
Created Date:  1984-03-19     Completed Date:  1984-03-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  45-80     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Administration, Oral
Administration, Topical
Angina, Unstable / drug therapy
Animals
Cardiac Surgical Procedures
Clinical Trials as Topic
Female
Heart Failure / drug therapy
Hemodynamics / drug effects
Humans
Hypotension / drug therapy
Injections, Intravenous
Kinetics
Myocardial Infarction / drug therapy
Myocardium / metabolism
Nitroglycerin / administration & dosage*,  adverse effects
Pregnancy
Surgical Procedures, Operative
Chemical
Reg. No./Substance:
55-63-0/Nitroglycerin

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


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