Angina, nitroglycerine treatment

Therapeutic opportunities for NO synthons include angina, for which nitroglycerin is effectively used, as well as penile erectile dysfunction. NOS inhibitors have demonstrated some protection in cerebral ischemia models and may be potentially beneficial in alleviating cell death associated with cerebral ischemia. l-NMA is under clinical study for treatment of sepsis. 

Nitroglycerin remains the dmg of choice for treatment of angina pectoris. It has also been found useful for the treatment of congestive heart failure, myocardial infarction, peripheral vascular disease, such as Raynaud s disease, and mitral insufficiency, although the benefits of nitroglycerin in mitral insufficiency have been questioned. 

Despite the limitations imposed by the physiology of the skin, several marketed controUed release transdermal dmg dehvery systems are available in the United States for example, scopolamine [51-34-3] for the treatment of motion sickness, nitroglycerin [55-63-0] for angina, estradiol [50-28-2] for the rehef of postmenopausal symptoms and osteoporosis, clonidine [4205-90-7] for the treatment of hypertension, fentanyl [437-38-7] as an analgesic, and nicotine [54-11-5] as an aid to smoking cessation. These systems are designed to dehver dmg for periods of one to seven days. 

Nitroglycerin Delivery Systems. Transderm-Nitro, Nitro-dur, and Minitran are all transdermal therapeutic systems that dehver nitroglycerin [55-63-0] mol wt 227.09, at a continuous, controlled rate through intact skin for treatment of angina (95). 

Nitroglycerin has long been used for the treatment of acute attack of angina pectoris, and its stable analogs are available to prevent the anginal attack. Nitrovaso-dilators such as sodium nitropmsside liberate NO from their molecules in the tissue (thus, called NO donors) and elicit actions via cyclic GMP like those seen with endogenously synthesized NO. 

As apart of Hie ongoing assessment, Hie nurse monitors the patient for Hie frequency and severity of any episodes of angina pain. With treatment, episodes of angina should be eliminated or decrease in frequency and severity. The nurse should report to Hie primary health care provider any chest pain that does not respond to three doses of nitroglycerin given every 5 minutes for 15 minutes. 

Bray CL, Jain S, Faragher EB, Myers A, Myers P, MacIntyre P, Rae A, Goldman M, and Alcorn M (1991) A comparison of buccal nitroglycerin and sublingual nitroglycerin in the prophylaxis and treatment of exertional (situation-evoked) angina pectoris. Eur. Heart J. 12 Suppl A 16-20. 

The drug nitroglycerin (glyceryl trinitrate), which is used in the treatment of angina pectoris, releases NO in the bloodstream and thereby leads to better perfusion of cardiac muscle. 

There is little doubt concerning the effectiveness of nitroglycerin in the treatment of angina pectoris. 

Since these nitrate-based compounds cause blood vessels to dilate, they are called nitrovasodilators. Nitrovasodilators have clinical utility in the treatment of angina and in the treatment of malignant hypertension (high blood pressure that is severely out of control). Some of the available nitrovasodilator products include amyl nitrite (4.228), nitroglycerin (4.229), isosorbide dinitrate (4.230), erythrityl tetranitrate (4.231), pentaery-thritol tetranitrate (4.232) and sodium nitroprusside (4.233). 

Nitroglycerine Isosorbide dinitrate Treatment of angina pectoris and second-line therapy in congestive heart failure... 

---