Angina prophylaxis

Passive transdermal dehvery systems on the market tend to be either matrix or membrane controUed. In matrix devices, the stmctural and molecular characteristics of the dmg-polymer matrix determine dmg release. Examples of polymer matrix-controUed diffusional systems for angina prophylaxis include Nitro-Dur and Nitrodisc, which provide transdermal dehvery of nitroglycerin [55-63-0], and Erandol, a tape that releases isosorbide dinitrate [87-33-2]. Matrix diffusional systems have been used for dehvering dmgs with a wide therapeutic index. 

For sustained daytime angina prophylaxis, nitrates are of limited value because "nitrate pauses of about 12 h are appropriate if nitrate tolerance is to be avoided. If attacks occur during the day, ISDN, or its metabolite isosorbide mononitrate, may be given in the morning and at noon (e.g ISDN 40 mg in extended-release capsules). Because of hepatic presystemic elimination, NTG is not suitable for oral administratioa Continuous delivery via a transdermal patch would also not seem advisable because of the potential development of tolerance. With molsidomine, there is less risk of a nitrate tolerance however, due to its potential carcinogenicity, its clinical use is restricted. 

Angina prophylaxis (nitroglycerin topical, transdermal, translingual spray, oral... 

If there is substantial concern about cardiovascular stress (hypertension or arrhythmia) during sexual intercourse in either sex, a dose of labetalol about 2 hours before the event may well be justified (taking account of other therapy already in use). But patients taking a p-blocker long term for angina prophylaxis have shown reductions in peak heart rate during coitus from 122 to 82 beats/min. 

Acute relief of an attack of angina pectoris or prophylaxis of angina pectoris... 

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. 

Q25 Drugs used in the treatment of prophylaxis of angina include all EXCEPT ... 

Indications. Verapamil is used as an antiarrhythmic drug in supraventricular tachyarrhythmias. In atrial flutter or fibrillation, it is effective in reducing ventricular rate by virtue of inhibiting AV-conduction. Verapamil is also employed in the prophylaxis of angina pectoris attacks (p. 308) and the treatment of hypertension (p. 312). Adverse effects Because of verapamil s effects on the sinus node, a drop in blood pressure fails to evoke a reflex tachycardia Heart rate hardly changes bradycardia may even develop. AV-block and myocardial insufficiency can occur. Patients frequently complain of constipation. 

Metoprolol is nsed in moderate hypertension, serions conditions of myocardial infarction, for preventing death of cardiovascular tissue, in angina, tachycardia, extrasystole, and for secondary prophylaxis after a heart attack. The most common synonyms are lopresor, betaloc, and others. 

Prophylaxis of ischemic complications in unstable angina and non-Q-wave Ml- —... 

Acute angina (nitroglycerin sublingual ortranslingual spray isosorbide din it rate sublingual amyl nitrite) For relief of acute anginal episodes prophylaxis prior to events likely to provoke an attack. 

Acute prophylaxis - A patient anticipating activity likely to cause angina should take 1 sublingual tablet (2.5 to 5 mg) approximately 15 minutes before the activity is expected to begin. 

It is indicated in hypertension, cardiac arrhythmias, longterm management of MI, hypertrophic subaortic stenosis, pheochro-mocytoma, migraine prophylaxis, angina pectoris, essential tremors. 

It is indicated in hypertension, angina pectoris, cardiac arrhythmia, post MI patients, adjunctive management of thyrotoxicosis and prophylaxis of migraine. 

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