Nitroglycerin variant

For variant angina, reduction in symptoms and nitroglycerin consumption as documented by a patient diary can assist the interpretation of objective data obtained from ambulatory ECG recordings. Evidence of efficacy includes the reduction of ischemic events, both ST-segment depression and elevation. Additional evidence is a reduced number of attacks of angina requiring hospitalization, and the absence of MI and sudden death. 

The capacity of the molten nitroglycerine to crystallize again in its original form was proposed by Hibbert [16] as evidence for the supposition that both variants are isomers (A) and (B) differing in chemical structure ... 

Bauer, J., Balthasar, J., and Fung, H., Application of pharmacodynamic modeling for designing time-variant dosing regimens to overcome nitroglycerin tolerance in experimental heart failure, Pharmaceutical Research, Vol. 14, No. 9, 1997, pp. 1140-1145. 

Organic nitrates (and nitrites) are simple nitric and nitrous acid esters of alcohols. They differ in their volatility for example, isosorbide dinitrate is solid at room temperature, nitroglycerin is only moderately volatile, whereas amyl nitrate is extremely volatile. These compounds cause a rapid reduction in myocardial oxygen demand followed by rapid relief of symptoms. They are effective in stable and unstable angina, as well as Prinzmetal s or variant angina pectoris. 

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