Document Detail

Nitrates and nitrites in the treatment of ischemic cardiac disease.
MedLine Citation:
PMID:  20539102     Owner:  NLM     Status:  MEDLINE    
The organic nitrite, amyl of nitrite, was initially used as a therapeutic agent in the treatment of angina pectoris, but was replaced over a decade later by the organic nitrate, nitroglycerin (NTG), due to the ease of administration and longer duration of action. The administration of organic nitrate esters, such as NTG, continues to be used in the treatment of angina pectoris and heart failure since the birth of modern pharmacology. Their clinical effectiveness is due to vasodilator activity in large veins and arteries through an as yet unidentified method of delivering nitric oxide (NO), or a NO-like compound. The major drawback is the development of tolerance with NTG, and the duration and route of administration with amyl of nitrite. Although the nitrites are no longer used in the treatment of hypertension or ischemic heart disease, the nitrite anion has recently been discovered to possess novel pharmacologic actions, such as modulating hypoxic vasodilation, and providing cytoprotection in ischemia-reperfusion injury. Although the actions of these 2 similar chemical classes (nitrites and organic nitrates) have often been considered to be alike, we still do not understand their mechanism of action. Finally, the nitrite anion, either from sodium nitrite or an intermediate NTG form, may act as a storage form for NO and provide support for investigating the use of these agents in the treatment of ischemic cardiovascular states. We review what is presently known about the use of nitrates and nitrites including the historical, current, and potential uses of these agents, and their mechanisms of action.
Vaughn E Nossaman; Bobby D Nossaman; Philip J Kadowitz
Publication Detail:
Type:  Historical Article; Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Cardiology in review     Volume:  18     ISSN:  1538-4683     ISO Abbreviation:  Cardiol Rev     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-10-13     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  190-7     Citation Subset:  IM    
Department of Pharmacology, Tulane University Medical Center, New Orleans, LA 70112-2699, USA.
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MeSH Terms
Amyl Nitrite / therapeutic use
Endothelium, Vascular / metabolism
History, 19th Century
History, 20th Century
Myocardial Ischemia / drug therapy*,  metabolism
Nitrates / history,  therapeutic use*
Nitric Oxide / metabolism
Nitrites / history,  therapeutic use*
Nitroglycerin / therapeutic use
Treatment Outcome
Vasodilator Agents / therapeutic use
Xanthine Dehydrogenase / metabolism
Grant Support
Reg. No./Substance:
0/Nitrates; 0/Nitrites; 0/Vasodilator Agents; 10102-43-9/Nitric Oxide; 55-63-0/Nitroglycerin; 8017-89-8/Amyl Nitrite; EC Dehydrogenase

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

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