Document Detail

Parenteral nitroglycerin: clinical usefulness and limitations.
MedLine Citation:
PMID:  6426795     Owner:  NLM     Status:  MEDLINE    
It would appear that nitroglycerin, which has been the time-honored therapy for angina pectoris, has a much broader therapeutic scope. Since the Food and Drug Administration has only recently released intravenous nitroglycerin for general clinical use, other clinical applications may develop in the future. Intravenous nitroglycerin appears to provide predictable and rapid lowering of left ventricular filling pressure and mean arterial pressure in patients with ischemic heart disease. The ability to increase cardiac output appears to be greatest in those patients with severe left ventricular failure. However, anti-ischemic effects are evident in all hemodynamic subgroups. Compared with sodium nitroprusside, nitroglycerin appears to have more favorable effects on intercoronary collateral flow, pulmonary artery pressure, and intrapulmonary shunting. In the perioperative setting, nitroglycerin appears to be as effective an afterload-lowering agent as nitroprusside in the majority of patients. In view of its more favorable effects on coronary collateral resistance, nitroglycerin may be preferable to nitroprusside for many such afterload-lowering applications, especially in patients with significant obstructive coronary disease. With greater clinical use, intravenous nitroglycerin will undoubtedly prove to be a valuable new tool for the management of patients with ischemic heart disease.
J T Flaherty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular clinics     Volume:  14     ISSN:  0069-0384     ISO Abbreviation:  Cardiovasc Clin     Publication Date:  1984  
Date Detail:
Created Date:  1984-07-20     Completed Date:  1984-07-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0213744     Medline TA:  Cardiovasc Clin     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  111-8     Citation Subset:  IM    
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MeSH Terms
Angina Pectoris / drug therapy*
Angina, Unstable / drug therapy*
Coronary Artery Bypass
Dose-Response Relationship, Drug
Heart Failure / drug therapy*
Hemodynamics / drug effects
Infusions, Parenteral
Myocardial Infarction / drug therapy*
Nitroglycerin / adverse effects,  therapeutic use*
Reg. No./Substance:

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

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