Cardiovascular Medicine Book

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Long Acting NitroglycerinAka: Long Acting Nitrates, Transdermal Nitroglycerin, Isosorbide

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  1. General
    1. Need 10-12 hours Nitroglycerin free interval per day
    2. Not proven to reduce Incidence of future events
  2. Indications
    1. Chronic Angina Pectoris
    2. Not indicated for acute Myocardial Ischemia
  3. Preparations: Long acting
    1. Isosorbide dinitrate (Isordil)
      1. Reg: 10 to 40 mg PO tid (7am, 12 noon, 5pm)
      2. SR: 40-80 mg PO bid (8am, 3pm)
    2. Isosorbide mononitrate
    3. Nitroglycerin sustained release (Nitro-Bid)
  4. Preparations: Transdermal
    1. Nitroglycerin 2% ointment (15 mg per inch)
      1. Start: 0.5 inch q8 hours
      2. Maintenance: 1-2 inches q8 hours
      3. Maximum: 4-5 inches q4 hours
    2. Transdermal Nitroglycerin
      1. Apply 1 patch for 12-14 hours per day
      2. Doses range from 0.1 to 0.8 mg per hour

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