Cardiovascular Medicine Book

Coronary Artery Disease

Congestive Heart Failure

Electrocardiogram

Examination

Hypertension

Inotrope

Hyperlipidemia

Pericardial Disorders

Hypotension

Obstetrics Chapter related topics

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Long Acting Nitroglycerin

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

Isosorbide (C0022251)

Definition (CHV) a drug used to prevent or treat chest pain (angina).
Definition (MSH) 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma.
Definition (NCI) An organic nitrate with vasodilator activity. Isosorbide relaxes vascular smooth muscle by formation of the free radical nitric oxide (NO), which is identical to the endothelium-derived relaxing factor (EDRF). NO activates guanylyl cyclase, thereby increasing the synthesis of cGMP within smooth muscle. Elevated cGMP levels in smooth muscle activate cGMP-dependent kinase activity that leads to release of sequestered Ca2+. In turn, free Ca+ triggers dephosphorylation of light chain myosin and relaxation of peripheral arteries and veins. In addition isosorbide relaxes coronary arteries, thereby increasing the blood circulation through the ischemic area.
Concepts Carbohydrate (T118) , Pharmacologic Substance (T121)
MSH D007547
SnomedCT 108478001, 386853004
English Isosorbide, D-Glucitol, 1,4:3,6-dianhydro-, isosorbide, Isosorbide [Chemical/Ingredient], Isosorbide (product), Isosorbide (substance), ISOSORBIDE
Swedish Isosorbid
Czech isosorbid
Finnish Isosorbidi
Russian IZOSORBID, ИЗОСОРБИД
Japanese イソソルビド
Croatian IZOSORBID
Spanish Isosorbida, isosorbida (producto), isosorbida (sustancia), isosorbida
Polish Izosorbid
French Isosorbide
German Isosorbid
Italian Isosorbide
Portuguese Isossorbida
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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