Document Detail


Organic nitrates: new formulations and their clinical advantages.
MedLine Citation:
PMID:  8638525     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The organic nitrates have been used for more than a century in the management of patients with myocardial ischemia. The most commonly used agents at this time include nitroglycerin, isosorbide dinitrate, and isosorbide-5-mononitrate. These agents all exert their therapeutic effects through biodegradation to nitric oxide, which stimulates guanylate cyclase in vascular smooth muscle cells with the production of cyclic guanosine monophosphate. The latter induces vasodilation by reducing the availability of ionized calcium to the contractile proteins. Tolerance to the organic nitrates occurs when the agents are administered in an attempt to provide therapeutic effects throughout 24 hours each day. There are probably several mechanisms responsible for nitrate tolerance, but there is no evidence at this time that concurrent medications will modify the development of tolerance. The only available method at this time is to give these agents intermittently to provide a period of washout. In so doing, it is possible to provide therapeutic nitrate effects for approximately 12 hours throughout each 24-hour period.
Authors:
J A Parker
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  77     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-07-10     Completed Date:  1996-07-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  38C-40C     Citation Subset:  AIM; IM    
Affiliation:
Kingston General Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / drug therapy*
Humans
Isosorbide Dinitrate / administration & dosage,  therapeutic use*
Nitrates / pharmacology,  therapeutic use*
Nitroglycerin / administration & dosage*
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Nitrates; 55-63-0/Nitroglycerin; 87-33-2/Isosorbide Dinitrate

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


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