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Congestive Heart Failure

Coronary Artery Disease

Electrocardiogram

Examination

Hyperlipidemia

Hypertension

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Pericardial Disorders

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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

Isosorbide (C0022251)

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.
ConceptsCarbohydrate (T118) , Pharmacologic Substance (T121)
MSHD007547
EnglishIsosorbide, ISOSORBIDE PREPARATION
Spanishisosorbida
Parent ConceptsSorbitol (C0037688), Vasodilator Agents (C0042402), [CV250] ANTIANGINALS (C0724739), Diuretics, Osmotic (C0012800), Drug allergen (C1320237), Hyperosmotic agent for glaucoma (C1562419), Hyperosmotic preparation for glaucoma (C1562533)
SourcesAOD, MSH, MTHSPL, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)



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