Download Cardiovascular Drug Therapy: Nitrate Therapy by Adam Schneeweiss PDF

By Adam Schneeweiss

The· first assembly of the cardiovascular drug remedy discussion board happened on April 13-15, 1988 in Montreux, Switzerland. during this assembly, which was once closed to the general public, nearly one hundred fifty major investigators within the box of cardiovascular drug treatment, either lecturers and from the pharmaceutical undefined, mentioned the state-of-the-art and destiny traits of this quickly increasing box. The discussions focused on 4 significant themes: (1) ischemic center ailment; (2) center failure; (3) hyper­ pressure; (4) arrhythmias. those themes have been mentioned through 4 committees in parallel, and thereafter the details have been reviewed via the full discussion board. This framework allowed either in depth and interdisciplinary discussions. This publication, the 1st ebook of chosen subject matters from the assembly, focuses frequently on nitrate treatment in ischemic center disorder and middle failure. Adam Schneeweiss, MD Chairman v Contents commencing comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Presentation of the Sir Thomas Lauder Brunton Award for impressive Nitrate study . . . . . . . . . . . . . . . . . . . . . . . . . . three Origins of indicators in center Failure - Relevance in overview of latest medications . . . . . . . . . . . . . . . . . . . . five Mononitrates in Congestive center Failure . . . . . . . . . . . . . . . . . nine Are There variations among a number of the Formulations of Nitrates in middle Failure? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . eleven long term Nitrate remedy - A Decade of adjusting recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Nitrate remedy in Angina Pectoris . . . . . . . . . . . . . . . . . . . . . . . . 23 Mononitrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Transdermal management of Nitrates . . . . . . . . . . . . . . . . . . . fifty three Nitrates in Angina Pectoris - purpose of Use and Avoidance of barriers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixty seven remedy of Congestive middle Failure - precis . . . . . . . .

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Extra info for Cardiovascular Drug Therapy: Nitrate Therapy

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This finding shows some attenuation of the effect of ISDN, but no cross-tolerance to nitroglycerin. References 1. Zelis R, Mason DT (1975) Isosorbide effect on the vasodilator re- sponse to nitroglycerin. JAMA 234: 166-170 2. Parker JO, Fung H-L, Ruggirello BS, Stone JA (1983) Tolerance to isosorbide dinitrate: rate of development and reversal. Circulation 68: 1074-1080 3. Stewart DJ, Elsner D, Sommer 0, Holtz J, Bassenge E (1986) Altered spectrum of nitroglycerin action in long-term treatment: nitroglycerinspecific venous tolerance with maintenance of arterial vasodepressor potency.

0 on 40 mg twice daily, representing a reduction of 48 % , 50 % , and 67 % , respectively. Sublingual nitroglycerin consumption decreased similarly. Thus, IS-5-MN exerts a potent antianginal effect, with no evidence of early tolerance. Bidoggia et al. [6] compared IS-5-MN with placebo in 20 patients with chronic stable angina pectoris. Exercise tests were performed after placebo and after one oral dose of IS-5MN, 20 mg. On placebo 18 of the patients suffered angina pectoris during the exercise test, compared with only three patients on IS-5-MN.

In a recent review Boertz and Bonn [22] have suggested that sustained-release formulations may be an optimal solution to the problem of tolerance. On the one hand, it is now known that long-lasting, unfluctuating plasma concentrations of more than 300 ng IS-5-MN/ml cause a loss of action. The efficacy may be maintained by a regimen in which an interval with considerably reduced nitrate levels is guaranteed. On the other hand, a dosage regimen that achieves steady-state plasma concentrations which fluctuate between 100 and 300 ng IS-5-MNI ml (as occurs with conventional tablets of ISDN, 20 mg three times daily) showed no clinically significant loss of efficacy even after 4 weeks of use.

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