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At least 919 records · Page 51Linked to original sources
PubMed1975

[Efficacy of a new slow-release isosorbide dinitrate preparation in myocardial infarction (author's transl)].

A new slow-release isosorbide dinitrate preparation (ISDN retard, Boehringer Mannheim) was investigated in a controlled study (double blind/cross over) in 20 patients with clear symptoms of coronary insufficiency after myocardial infarction, comparing the ECG on effort with that under placebo treatment. A favourable effect on the symptoms of coronary insufficiency could be demonstrated under standardised conditions on a bicylce ergometer 4 hours after oral ingestion of ISDN. The ST interval of the ECG was significantly lowered (p less than or equal to 0.025) under comparable cardiac work. The prolonged action of ISDN retard was also shown by a significant reduction in systolic and diastolic blood pressure at rest, during and after effort. Simultaneously, there was a slight but not-significant rise in heart rate.

Administration, Oral↗
PubMed2002

[Administration of various dosages of retard isosorbide-5-mononitrate in patients with stable angina pectoris on combined therapy].

We studied efficiency of a retard form of isosorbide-5-mononitrate (Mono Mac 50D) in patients with stable angina pectoris (NYHA class II and III). This efficiency was assessed by clinical examinations and 24-h Holter ECG monitoring before and after the treatment. 16 patients with angina of functional class II and 12 patients with functional class III received combined treatment: prolonged mononitrate (Mono Mac 50D), disaggregants, beta-blockers, ACE inhibitors and calcium antagonists (on demand). In angina functional class II Mono Mac 50D was given in a single dose 50 mg/day (1 tablet) in the morning for 4 weeks, in functional class III angina the drug was taken for 2 weeks in a dose 50 mg/day, the next two weeks in a dose 100 mg/day once in the morning. The other drugs were taken in moderate recommended doses. After two weeks of treatment with 50 mg/day Mono Mac 50D angina symptoms attenuated (in functional class II) and the patients' condition improved (in functional class III). In elevation of the dose to 100 mg/day the latter patients improved still greater. We think it valid to use a single 50 mg/day dose in angina functional class II and 100 mg once a day in functional class III.

Adult↗
PubMed1998

[Multiple dose pharmacokinetic and bioavailability studies of oral sustained release and conventional formulations of isosorbide-5-mononitrate in healthy volunteers].

The pharmacokinetics of a new sustained release tablets (40 mg, qd) of isosorbide-5-mononitrate (IS-5-MN) was investigated together with a conventional preparation (20 mg, bid) after multiple oral administration in ten healthy human subjects using an open, randomized two-way crossover experimental design. Based on three statistical analyses of the area under the plasma concentration-time curve (AUC), the two tablet formulations are judged to be bioequivalent (P > 0.1), with a relative bioavailability of 108.95% for the IS-5-MN sustained release formulation. Pharmacokinetic data showed that the sustained release formulation reached mean peak plasma levels significantly later and lower minimum plasma concentration (Cmin), compared with the conventional preparation. But no statistically significant difference was found for other pharmacokinetic parameters including peak plasma levels (Cmax), AUC, elimination constant (Ke), elimination half-life (T1/2) and fluctuation index (FI) between the two preparations (P > 0.05).

Adult↗
PubMedDate not supplied

Potentiating potassium nitrate's desensitization with dimethyl isosorbide.

Desensitization of hypersensitive teeth by the combination of dimethyl isosorbide (DMI) and potassium nitrate (KNO3) is more effective than when KNO3 is used alone. KNO3/DMI work together to desensitize hypersensitive teeth at a higher, quicker, and more profound and lasting level.

Adult↗
PubMed1975

Coronary circulation in patients with and without coronary artery disease and the effects of chewable isosorbide dinitrate.

Coronary arteriograms of 38 patients with suspected coronary artery disease (CAD) were first evaluated to decide whether or not the disease was present and, if so, whether easily recognizable collateral channels were demonstrated. In this evaluation, we found CAD in 26 of the 38 patients. Eighteen of 21 patients with severe obstructions or occlusions had functioning collateral vessels. The films were then evaluated a second and third time to determine the effects of chewable isosorbide dinitrate (ISDN) on the coronary circulation. Visual inspection of the arteriograms revealed significant increases in 1) the apparent number and diameter of collateral vessels, 2) the opacification of vessels distal to occlusions, and 3) the diameter of coronary arteries following the administration of 2.5, 5, or 10 mg chewable ISDN. Computer analysis of the arteriograms showed an average 16% increase in the diameters of specific segments of major coronary arteries following ISDN. All patients showed some degree of vasodilatation following ISDN; however, patients without CAD consistently showed more vasodilatation than patients with disease. Mean aortic blood pressure decreased an average of 10% following ISDN. These results demonstrate that the chewable form of ISDN reliably dilates the coronary arteries in patients both with and without CAD and enhances the collateral circulation to the ischemic areas in patients with CAD.

Adult↗
PubMed2002

[Long-acting isosorbide dinitrate and molsidomin in the treatment of effort angina in patients with arterial hypotension].

AIM: To compare effectiveness and tolerance of isosorbide dinitrate (ID) and molsidomin in retard forms in patients with effort angina (EA) in combination with arterial hypotension (AH). MATERIAL AND METHODS: A randomised blind cross-over trial with lead-in placebo period trial compared efficiency of retard ID and molsidomin in 65 EA patients with AH (group 1) and 40 normotensive patients with coronary heart disease (group 2). RESULTS: Bicycle exercise has shown that retard ID and molsidomin retard were highly effective in group 1 (97% vs 92% 0 and group 2 (100 and 95%, respectively). Molsidomin retard treatment improved myocardial perfusion and was effective for a year in both groups. CONCLUSION: Retard ID was highly effective in anginal patients with AH but its tolerance is also high. Molsidomin retard is proposed as alternative treatment in anginal patients with AH.

Angina Pectoris↗
PubMed2002

Head-up tilt table testing with low dose sublingual isosorbide dinitrate in the evaluation of unexplained syncope: a comparison with isoproterenol infusion.

OBJECTIVES: To investigate the value of head-up tilt table testing (HUTT) with low-dose isosorbide dinitrate (ISDN) in the evaluation of patients with unexplained syncope and to compare the results of HUTT with ISDN and HUTT with isoproterenol. PATIENTS AND METHODS: Forty-three patients with unexplained syncope (21 women, with a mean age of 45.4 18 years) and 18 control subjects without syncope (eight women, with a mean age of 45.8 12 years) were tilted (80 ) for 30 min (passive period). When this period was negative, 2.5 mg sublingual ISDN was administered and patients were observed for an additional 15 min (ISDN period). The first 25 patients studied (10 women, with a mean age of 46.2 18 years) were tested again after a mean period of three weeks using the isoproterenol protocol. After the passive period, intravenous isoproterenol was administered (1 to 3 g/min) to patients lying in the supine position, and they were tilted again (80 ) for 10 min (isoproterenol period). RESULTS: During the passive period, 10 of 43 patients (23%) had a positive response compared with none in the control group. Syncope was observed in another 14 patients and in two control subjects during the ISDN period. The positivity rate (sensitivity) and specificity of HUTT with low dose ISDN were 56% and 89%, respectively. Among the patients (n=25) tested with the isoproterenol protocol, 14 (56%) patients had syncope. The agreement rate between the protocols was 78.9%. CONCLUSIONS: The total positivity rate of HUTT significantly increased with the use of the low dose ISDN, while specificity remained high. Due to its simplicity and tolerability, the ISDN protocol can be chosen when the results of the passive period tilt testing are negative.

Administration, Sublingual↗
PubMed2002

[The randomized controlled trial of isosorbide mononitrate plus propranolol compared with propranolol alone for the prevention of variceal rebleeding].

OBJECTIVE: The aim of this study was to test the effectiveness of isosorbide-5-mononitrate (IM) as an adjunct to propranolol (PR) in the prevention of variceal rebleeding. METHODS: Seventy-six cirrhotic patients with variceal bleeding were randomly assigned to treatment with PR + IM (34 patients) or PR alone (32 patients). RESULTS: Seven patients in the PR + IM group and 13 in the PR group had rebleeding during the 1 year after randomization. The actuarial probability of rebleeding 1 years after randomization was lower in the PR + IM group but the difference was not significant (P = 0.09). However, by adding an additional 8 months of follow-up, the decrease in the risk of rebleeding reached statistical significance (P = 0.05). No significant difference was found in rebleeding index and survival. The multivariate Cox analysis indicated both treatment (P = 0.04), severity of liver disease (P = 0.03) and age (P = 0.045) were factors predictive of rebleeding and second, that PR + MI reduced the risk of rebleeding by half (relative risk: 0.54). CONCLUSION: These results suggest that the addition of IM improves the efficacy of PR alone in the prevention of variceal rebleeding in cirrhotic patients. However no beneficial effects were observed on other parameters reflecting the efficacy of treatment.

Adult↗
PubMed1992

Combined gallopamil and isosorbide-5-mononitrate in "mixed" angina pectoris.

The efficacy of combining gallopamil and isosorbide-5-mononitrate (IS-5-MN) was evaluated in 15 patients with "mixed" angina and documented coronary artery disease who participated in a 4-week, double-blind, double-dummy, crossover, placebo-controlled trial. After the first week of the placebo phase (single-blinded), all patients received in three different weeks IS-5-MN 20 mg three times daily, gallopamil 50 mg three times daily, and the same dosages of IS-5-MN and gallopamil three times daily. Exercise tolerance, and peak values of heart rate, systolic blood pressure, double product (DP/100), and ST-segment were evaluated with a treadmill test at the end of each phase. The improvement in exercise tolerance obtained by the combination of the two drugs was significantly greater (p < 0.01) than that achieved by IS-5-MN but not that by gallopamil monotherapy (NS). This effect was accompanied by significant (p < 0.05) reduction (-61%) in ST-segment and significant (p < 0.05) increment (+8%) in peak heart rate only after administration of the combination of the two drugs. The number of ST-depression (ST-) > 1 mm or ST-elevation (ST+) episodes on 24-h Holter monitoring lasting > or = 1 min were also noted in all patients at the end of each phase of the trial.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Effects of isosorbide dinitrate on regional cerebral blood flow and intracranial pressure in cats].

The effects of isosorbide dinitrate (ISDN) on regional cerebral blood flow (rCBF) and intracranial pressure (ICP) were examined in cats. A low dose of ISDN (2.5 micrograms/kg/min) infusion did not show any changes in cerebral hemodynamics. During high dose of ISDN (5.0 micrograms/kg/min) or NTP (5.0 micrograms/kg/min) infusion, mean blood pressure (mBP) decreased by 10 to 20% accompanied by decreased cerebral perfusion pressure (CPP: mBP-ICP), however, rCBF or ICP did not change. It is concluded that intravenous administrations of ISDN in a dose of 2.5-5.0 micrograms/kg/min that produce slight decrease in blood pressure did not influence on cerebral hemodynamics.

Animals↗
PubMed1992

[ Combined therapy with isosorbide dinitrate, propranolol and nifedipine in patients with chronic ischemic heart disease].

Forty six patients with stable effort angina were treated with a combination of propranolol, nifedipine, and isosorbide dinitrate which produced a more profound anti-antianginal effect than each of them given alone. The combination also exerted more marked antihypertensive and antiarrhythmic effects. The combined therapy with the three drugs caused a moderate reduction in heart rate and peripheral resistance, but failed to result in clear-cut disturbances in the orthostatic regulation of the circulatory system. There was a more infrequent and less pronounced ST-segment depression, less marked pressor responses and higher heart rate with the combined therapy during exercise; the cardiac index also increased as before therapy. Physical fitness increased to a greater extent than with monotherapy. The combined therapy with three drugs is indicated when monotherapy fails and that with two agents is indicated when patients have concurrent essential hypertension and cardiac arrhythmias.

Adult↗
PubMed1992

[Studies on transdermal delivery system of isosorbide dinitrate].

A transdermal delivery system of isosorbide dinitrate (ISDN-TDS) and an HPLC method for the measurement of ISDN were developed. The system is composed of backing, drug reservoir, control membrane, contact adhesive and protective layer. The influences of drug reservoir, solvent, control membrane, viscosity and penetration enhancer azone on the release of ISDN were investigated. The cumulative released amount of ISDN/time profile indicated that ISDN was permeated through excised skin in a zero-order kinetic in 48 h. The release of ISDN from ISDN-TDS can last 72 h at least. The mean permeation rate is 13.76 micrograms.h-1/cm2. Releasing ISDN from ISDN-TDS was more stable than that from Frandol tape-s whose release profile was found to follow a linear Q vs t1/2 relationship with a release flux of 114.39 micrograms.h-1/cm2.

Administration, Cutaneous↗
PubMed1992

[Isosorbide dinitrate inhibits in vitro platelet aggregation at submicromolar concentrations].

Nitrate derivatives have in vivo and in vitro platelet anti-aggregant properties in addition to their vasodilatory effects. The mode of action is related to increased intracytoplasmic cyclic GMP concentrations. It has been shown that isosorbide dinitrate (ISDN) has this type of platelet anti-aggregant activity but the reported results about the active concentrations and the inhibited pathways of activation are contradictory. This study was designed to determine whether ISDN has in vitro platelet anti-aggregant activity at low doses and to verify if this effect is selective by aggregation induced by ADP. Finally, a possible potentialisation of the inhibitors due to ISDN was looked for with cyclic nucleotide phosphodiesterase inhibitors and with agents simulating the effect of adenylate cyclase. The results showed that: 1) ISDN had platelet anti-aggregant activity in vitro at concentrations of about 10-7 M, 2) that this effect was not limited to the aggregation induced by ADP as the aggregation induced by PAF-acether was also inhibited by low dose ISDN, 3) of the cyclic nucleotide modulators tested, only quercetine (flavonoide) potentialised the effects of ISDN.

Cyclic GMP↗
PubMed1992

[Effects of isosorbide dinitrate on coronary and systemic circulation in children: comparison with dipyridamole].

The effects of isosorbide dinitrate (ISDN) on the coronary and systemic circulation were evaluated in comparison with the effects of dipyridamole (DP) in 8 children with histories of Kawasaki disease and angiographically normal coronary arteries. ISDN (100 micrograms/kg) was administered as an intracoronary injection. DP was administered intravenously at the rate of 0.56 mg/kg for 4 min. In the coronary circulation, DP induced a significant reduction of the afterload, resulting in an increase in cardiac output. However, the pulmonary artery pressure, pulmonary capillary wedge pressure and left ventricular end-diastolic pressure, which are related to the preload, were significantly reduced one min after the ISDN injection. The systolic blood pressure was reduced, while the heart rate was increased. The cardiac output, pressure-rate product or systemic vascular resistance showed no significant change. The systolic work index, however, was significantly reduced. In the coronary circulation, DP significantly increased the coronary sinus blood flow due to dilatation of the resistant vessels. However, ISDN significantly dilated the conductant vessels by 4.0 to 12.9% in diameter. There was, however, no change in the coronary blood flow, coronary perfusion pressure nor coronary vascular resistance. The grade of dilatation of the coronary vessels caused by ISDN was lower in children than in adults.

Adolescent↗
PubMed1977

[A study of a new osmotic anti-glaucoma medication, isosorbide, in ophthalmic surgical practice (author's transl)].

Study of isosorbide effect in postoperative long term therapy. A preestablished randomized sequence allows one to compare two series of cases, cataract and glaucoma procedures, one series receiving the drug, the other series serving as a control. Based on the following clinical parameters, coaptation of wound edges, depth of anterior chamber, vitreous volume and position, iris position, analysis of the results demonstrates less complications in the treated serie. Efficacy, safety, scarcity of side effects of the drug, allows its prolonged administration in such clinical situations entailing treatment of postoperative ocular hypertension.

Aged↗
PubMed1992

[Lack of tolerance after administration of delayed-action isosorbide-5-mononitrate for 3 days in patients with exercise-induced silent ischemia: control with placebo].

In order to assess the development of tolerance we analyzed in a placebo-controlled study the effect of monotherapy with isosorbide-5-mononitrate (IS-5-MN) 60 mg in a controlled release formulation (Durules) once-a-day. The IS-5-MN was evaluated after the first dose and after once-a-day therapy for three days in 11 ambulatory patients (10 males, 1 female, aged 54 +/- 9 years) with stable exercise-induced silent myocardial ischaemia and significant coronary stenoses. The drug was given at 8 o'clock in the morning, and a bicycle ergometer exercise test was performed after 4 hours. The ST segment depression was evaluated by a computer-assisted system. Standing blood pressure decreased during all three periods of active treatment with IS-5-MN, (in comparison with placebo p < 0.001 and p < 0.01, p < 0.01 respectively). Heart rate did not change significantly. Compared with placebo baseline values, ischaemic threshold increased during the first day of treatment (188 sec, p < 0.0001 at 4 hours), and to a lesser extent both in second (103 sec, p < 0.003) and third day (116 sec, p < 0.003). The total exercise time increased during all three days of active therapy but significantly so only during the first day. The exercise stress test performed in the 5th day during placebo demonstrated a high reproducibility of ischaemic-threshold (235 vs 241 sec, p: ns), implying that the improvement during the active treatment with IS-5-MN was not due to a "training effect". Headache in 2 patients was the only significant side-effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Delayed-Action Preparations↗
PubMedDate not supplied

[Isosorbide 5-mononitrate (delayed release) in stable effort angina].

This work has been carried out to evaluate over a short and medium space of time (100 days) the efficacy, tolerance and haemodynamic repercussion of 50 mg of sustained release Isosorbide 5-Mononitrate administered once day to patients with stable effort angina in a random and prospective study, which was double blind crossover and placebo-controlled. In this study we included 10 patients who showed positive exercise test using clinical (angina) and electrocardiographic (ischemic drop of the ST greater than 1 mm) criteria. The assessment was done with cycloergometry starting with 30W and increasing by 20W every 2 minutes until angina appeared accompanied by an ischemic drop of the ST. The effort tests were done basally and at intervals of 4, 12 and 24 hours after the dose. The parameters studied were obtained on the 1st, 25th and 100th days of the study and were compared with those of the placebo. The time taken for the ST to 1 mm to fall (seconds) increased when evaluated after 4 and 12 hours on the 1st, 25th and 100th days in comparison with placebo (p < 0.05). The time taken for angina (seconds) to appear lengthened considerably when evaluated 4 and 12 hours after the dose not only on the 1st day but also on the 25th and 100th days in comparison with placebo (p < 0.05). The duration of the effort (seconds) was significantly greater after 4 and 12 hours on the 1st, 25th and 100th days when compared to that of the placebo (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Haemodynamic effects of intravenous isosorbide dinitrate in congestive heart failure].

The effects of intravenous infusion of isosorbide dinitrate (ISDN) were evaluated in 22 patients with congestive heart failure. These patients did not receive vasodilator therapy before this study. Seven of these patients (two bolus groups of 5.0 mg and 7.5 mg each) were infused bolusly. The mean PA, PCWP and mean RA decreased for 5 min and, after 60 min, they were back to the original levels. The mean Ao had an accentuated change when the 7.5 mg bolus was injected, but, apart from that, changes were minimal. The CI changed little and upwardly. ISDN was infused continuously in 10 patients (two infusion groups of 5.0 mg/hr and 7.5 mg/hr each) whose mean PA, PCWP and mean RA decreased for 15 min and continued downwardly but mildly for 120 min. The mean Ao did not change much and the CI slightly increased. Five of the 22 patients (bolus+infusion group of 5.0 mg and 5.0 mg/hr) showed rapid response but the parameters only slightly changed. Since this group included severe heart failure patients, the results observed were milder. The response of all 5 groups receiving ISDN infusion were confirmed by the serum ISDN concentration curve. These results indicate that continuous infusions of 7.5 mg/hr ISDN or bolus infusions of 5.0 mg and infusion of 5.0 mg/hr improved haemodynamics in patients with congestive heart failure.

Aged↗