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At least 991 records · Page 55Linked to original sources
PubMed1976

The effect of isosorbide dinitrate following experimental coronary occlusion.

The results of the present investigation indicate that ISDN infusion following experimental coronary occlusion in anesthetized dogs (1) lowers systemic, cardiac, and pulmonary blood pressures; (2) decreases systemic resistance; (3) has no significant effect on cardiac output, heart rate, and stroke volume; (4) decreases serum CPK levels; and (5) has little effect on blood biochemical parameters. These results suggest that ISDN may have a minimal effect on the ischemic heart by means of a slight decrease in peripheral vascular resistance and systemic blood pressure.

Animals↗
PubMed1983

Hemodynamic measurements and exercise testing to assess the development of tolerance against slow-release isosorbide dinitrate.

Hemodynamic measurements were carried out during exercise testing with floating catheterization in 12 male patients with multiple-vessel disease and stable angina pectoris after placebo, after acute treatment with 60 mg ISDN, and after 4 weeks treatment with 4 X 60 mg ISDN. The acute effects of ISDN at the maximal comparable workload were a 32% decrease in PAd, a 41% decrease in ST-segment depression, and a 35% increase in maximal workload. After 4 weeks therapy we found an attenuation of the efficacy of ISDN, with only a 12% decrease in PAd, a 33% decrease in ST-segment depression, and an 18% increase in maximal workload.

Blood Pressure↗
PubMed1976

[Effect of isosorbide dinitrate in relation to posture and age].

Rapid tilting into the 90 degrees upright position after 20 mg ISDN sublingually demonstrates a better orthostatic tolerance of the older group (in spite of a lower cardiac output) in comparison to the younger one. This can be explained by a higher tone of the resistance vessels and a stronger stretch resistance of the arteries of the elastic type (and probably of the veins), which are opposing the hydrostatic effects of orthostasis and guarantee a minor shifting of blood to the lower extremities. The increase of rigidity of the blood vessels with aging declares the better drug resistance of the older group but also points - on the other hand - to the borders of ISDN therapy.

Adolescent↗
PubMed1975

[Isosorbide dinitrate in coronary heart disease. Effects of a delayed-action preparation during acute load and in chronic use].

The antianginal effectivity of a sustained release isosorbiddinitrate Sorbidilat Retard drug was examined by the number of spontaneous attacks and by ergometry with a constant work load in a double blind trial with cross over technique. An effect on the stress duration, on the ST segment depression, on the "double product", on heart rate, and blood pressure could be proved, which is interpreted as an therapeutic advantage of serum against placebo. The number of spontaneous attacks could be reduced in the verum period significantly. Ergometry every 2 hour after drug adminstration shows an oral effectivity of about 10 hours.

Administration, Oral↗
PubMed1998

[Comparative efficacy, safety, cardio-hemodynamic effects of isosorbide dinitrate (ID) aerosol and sublingual tablets of nitroglycerin].

AIM: To study efficacy, safety, cardiohemodynamic effects of ID aerosol--isoket--for relief of anginal attacks and their prevention in long-term treatment. MATERIALS AND METHODS: 15 patients with ischemic heart disease suffering from stable angina class II-III. Isoket was tried for efficacy, tolerance, hemodynamic parameters, morphofunctional status of the heart, exercise tolerance. RESULTS: Isoket aerosol in a dose 1.25 mg as a single oral spray arrested anginal attacks in all the patients. In long-term regimens good antianginal effect was achieved in 60% of cases. The ID aerosol produces a fast antianginal effect, improves morphofunctional cardiac parameters and exercise tolerance. CONCLUSION: Isoket spray is effective and safe antianginal drug.

Administration, Inhalation↗
PubMed1995

[Influence of oral isosorbide dinitrate (ISDN) on parameters of blood flow in the coeliac trunk evaluated with doppler sonography].

Blood flow in the coeliac trunk was measured before and after oral application of ISDN (isosorbitol dinitrate) 10 or 20 mg. Clinical prognostic value of this test was evaluated. Investigation were carried out with a duplex-Doppler pulsatory wave. The quantitative hemodynamic method with estimation of PI and RI was applied to exclude the effect of angle and the vessel diameter. 44 healthy volunteers were examined. The ultrasonograph ACUSON 128 was used with the linear and sectorial head 3.5 MHz enabling measurement of the pulsatory wave (Doppler). All persons were divided into 4 groups: according to sex, the age, the dose of nitrate and the groups given placebo. Application of the ISDN led to increase values PI and RI. Application of placebo had no influence on the blood flow.

Adolescent↗
PubMed1983

Long-term treatment of patients with coronary heart disease using isosorbide dinitrate, nifedipine and molsidomine.

1. After initial acute administration of 20 or 60 mg ISDN, 2 mg molsidomine and 20 mg nifedipine, a clear effect on the circulation and an increase in work tolerance is detectable. 2. Following 4 weeks' treatment with 3 X 20 mg ISDN, there is no essential loss of action in the venous branch or with respect to working capacity. 3. After 4 weeks' treatment with 3 X 60 mg ISDN, the improvement in working capacity is partially retained, but the action on the venous branch is significantly poorer. 4. During 4 weeks' treatment with 3 X 20 mg nifedipine, there is no essential loss of action in the arterial or venous branches, or with respect to working capacity. 5. Our results with continuous high doses of ISDN indicate that high doses should be used only in monitored exceptions.

Adult↗
PubMed1987

Gastrointestinal therapeutic system delivering of a water insoluble drug: isosorbide dinitrate (ISDN).

An oral therapeutic system can only be effective for soluble drugs. If no suitable salt of a drug can be found, then an osmotic agent such as sodium chloride or mannitol has to be used in a modified two-chamber system, or the osmotic dispenser with collapsible supply container. A one-chamber gastrointestinal therapeutic system (GTS) is proposed which is capable of delivering insoluble drug at a relatively constant rate. The unit consists of a tablet containing the insoluble drug and the soluble carrier, surrounded by a rate-controlling membrane with a delivery orifice. If the unit is in contact with fluid, water will pass constantly through the membrane into the tablet, dissolve the carrier which will be pumping out the insoluble drug through the delivery orifice. The effect was studied of variable content and weight of the tablet, size of the delivery orifice and thickness of the membrane on the rate of insoluble drug release from the GTS.

Excipients↗
PubMed1989

[Clinical effects of isosorbide dinitrate in the transdermal spray (TD Spray Iso Mack) form].

The authors report on their experience with the transdermal spray, TD spray Iso Mack. Using a graded ergometric test, the authors examined 11 patients with angina on exertion before and 60 minutes after administration of 60 mg of the effective substance by the transdermal route. The average threshold of ischaemia and work tolerance increased significantly and the ECG depression of segment S-T receded. In an open trial six patients were investigated with angina on exertion during three-week treatment with the spray--twice a day 60 mg by the transdermal route--as compared with standard treatment. The number of attacks and consumption of sublingual nitroglycerin decreased significantly. Five patients were subjected to haemodynamic examination before and repeatedly after application of 60 mg of the spray. A significant drop of the filling pressures occurred which persisted for 6 to 8 hours.

Administration, Cutaneous↗
PubMed1994

[The effect of diuretics on the magnitude of the effect of isosorbide dinitrate given as a single dose and after long-term administration. Ergometric study in patients with stable angina pectoris].

The authors assessed in 24 men with stable angina pectoris, using means of ergometry, the antiischaemic and antianginose effects of a combination of the nitrate Iso-Mack retard and the diuretic Moduretic. The effects were compared with the effects of Iso-Mack retard administered alone and with the effects of placebo. The examination was made after a single dose of the drugs and after three-week administration. The authors revealed that a single dose of the diuretic significantly enhanced the effects of nitrate. During long-term administration the diuretic did not prevent a significant diminution of the nitrate effects. Finally the authors discuss possible mechanisms of development of tolerance for nitrates and possibilities how to influence this tolerance by a diuretic.

Adult↗
PubMed2006

The effect of intermittent administration of sustained release isosorbide dinitrate (sr-ISDN) in rats with volume overload heart.

Recently, it has been reported that intermittent administration of nitrate, with a nitrate-free interval of 10 to 12 hr eliminated expression of tolerance, and maintained its hypotensive effect. In the present study, we evaluated whether nitrate tolerance developed or not with an intermittent administration of sr-ISDN (5 mg/kg/ once a day) in Wistar rats. The effect of this administration protocol for sr-ISDN on the volume overload heart model, aortovenous fistula, was also examined. Furthermore, blood pressure was monitored by radio telemetry during sr-ISDN (5 mg/kg/once a day) administration. Nitrate tolerance did not develop, and eccentric hypertrophy due to volume overload was moderated by sr-ISDN administration. Sr-ISDN administration maintained blood pressure lower level than the placebo group. In conclusion, prolonged intermittent administration of sr-ISDN maintained its hypotensive effect during the entire experiment period, without developing tolerance, and moderated efferent hypertrophy with attenuated volume overload.

Analysis of Variance↗
PubMed1982

[Hemodynamic effects of intravenous isosorbide dinitrate in acute myocardial infarct].

The hemodynamic effects of intravenous isosorbiddinitrate (ISDN) were studied in 15 patients with acute myocardial infarction. Pressure and flow parameters were measured by right heart and radial catheterization and by the thermodilution method. 3-9 mg/hour ISDN was infused intravenously and the hemodynamic values were measured during half an hour in clinically stable state. The statistical analysis was carried out by paired Student's t-test and factors analysis. After ISDN therapy 10 patients showed a significant fall in pulmonary capillary pressure (-24%), 9 a rise in stroke volume index (+21%) and cardiac index (+13%). Two patients only exhibited a rise in pulmonary capillary pressure (+10%) and one a fall in cardiac index (-5%). ISDN changes in pulmonary capillary pressure, stroke volume and cardiac output were mainly due to changes in pulmonary and systemic vascular resistances and much less to those in the systemic venous bed. It can be supposed that intravenous ISDN behaves more like a mixed than a venous vasodilator and can be recommended for acute myocardial infarction patients with high pulmonary capillary pressure and low cardiac output.

Adult↗
PubMed1983

Hemodynamic and hormonal response to induced hypotension with isosorbide dinitrate and nitroglycerin during anesthesia.

Changes in hemodynamics, plasma catecholamines, and PRA in response to controlled hypotension induced with ISDN (n = 10, mean dose 15.5 micrograms kg-1 min-1) and NTG (n = 7, mean dose 5.5 micrograms kg-1 min-1) were studied during neuroleptanesthesia in patients undergoing facial and neck surgery. Before the commencement of vasodilator infusion the patients were pretreated with metoprolol 0.1 mg kg-1. In addition, enflurane was used to obtain the desired hypotensive level. During ISDN induced hypotension, MAP was reduced from 83 to 63 mm Hg (p less than 0.001). Continuous infusion of NTG resulted in a decrease of MAP from 81 to 53 mm Hg (p less than 0.01). In both groups, HR decreased by 10% (p less than 0.05). For both vasodilators the reduction of MAP was associated with a marked decrease in SVRI (p less than 0.01), while Cl remained largely unchanged. The hemodynamic responses to the two vasodilators were similar, except that NTG reduced PAMP (p less than 0.01) and increased intrapulmonary shunt volume (p less than 0.01). The anesthetic technique attenuated catecholamine and renin release, suppressed reflex tachycardia, and prevented rebound hypertension.

Adolescent↗
PubMed1983

[Effects of intravenous infusion of isosorbide dinitrate (ISDN) on acute experimental congestive heart failure].

Experiments were undertaken to examine whether and how intravenous infusion of ISDN ameliorated hemodynamics of anesthetized dogs with congestive heart failure. A model of acute congestive heart failure with markedly high left ventricular end-diastolic pressure (LVEDP) and low cardiac index (CI) was induced by occlusion of the left anterior descending coronary artery (LAD) following 30-min infusion of dextran solution containing propranolol in halothane anesthetized open-chest dogs. Five minutes after occlusion of LAD, intravenous infusion of ISDN (100 and 500 micrograms/kg/min for 5 min) decreased the elevated LVEDP, aortic pressure and systemic vascular resistance, and enhanced the reduced CI. These changes produced by ISDN were significant (P less than 0.05 or P less than 0.01) as compared with values just before infusion of ISDN. ISDN at the same doses slightly reduced LVEDP, but did not increase CI in normal dogs which were not subjected to the coronary occlusion and dextran infusion. These results indicate that intravenous infusion of ISDN reduces both pre- and after-load and increases CI in dogs with heart failure, demonstrating that ISDN is useful for the vasodilator therapy of heart failure.

Animals↗
PubMed1992

[Isosorbide dinitrate in the treatment of coronary insufficiency].

The improvement of our understanding of the pharmacology of nitrate derivatives has allowed rationalisation of their use in the treatment of coronary artery disease. The comprehension of the evolution of the sensitivity of the vessel wall to nitrate vasodilatation with time has enabled definition of a rhythm of administration which preserves therapeutic efficacy: a daily therapeutic window of 8 to 10 hours. The introduction of new galenic forms (slow release oral preparations and transdermal patches) facilitates the practical application of the "optimal" pharmacokinetic profile. A single daily dose of slow release ISDN is effective in controlled trials versus placebo in the treatment of chronic stable angina. Many clinical trials have also shown the synergy of the anti-anginal effects of ISDN and betablockers, both in single dose studies and during prolonged administration. These therapeutic windows are not adapted to the treatment of acute coronary insufficiency (unstable angina, myocardial infarction); however, it has recently been shown that the use of small, fixed doses of intravenous ISDN over a 3 day period is usually adequate for controlling acute coronary insufficiency and is not associated with the phenomenon of tolerance.

Adrenergic beta-Antagonists↗
PubMed1982

[Hemodynamic effects of intravenous isosorbide dinitrate in chronic heart failure (author's transl)].

During cardiac catheterization, isosorbite dinitrate (ISDN) was given intravenously to ten patients with confirmed left ventricular failure (10 NOMC, 1 ischemic cardiopathy, 1 valvular disease). When the left ventricular filling pressure was above 15 mmHg and the systemic systolic pressure exceeded 100 mmHg, a 500 gamma (first half of patients) or 800 gamma (second half of patients) bolus of ISDN was given intravenously, followed by an infusion of 2.5, 5 or 10 mg ISDN per hour. In all patients, the functional tolerance was excellent ; the heart rate remained unchanged and the systolic systemic pressure decreased only slightly (10 %). Left ventricular filling pressures returned to normal in four patients, decreased significantly in three, and remained unchanged in three. The cardiac output increased significantly in four patients. The poor initial hemodynamic conditions and the doses given, subsequently considered insufficient especially during the first part of the study, probably explain why ISDN was only partly effective.

Cardiac Catheterization↗
PubMed1989

[Hemodynamic effect of subchronic therapy with 120 mg isosorbide dinitrate in a slow release form in minimal to moderate post-infarct heart failure].

In 16 patients (12 male, 4 female; age 48-73 years, mean = 62.2 years) with left heart failure NYHA Class II-III after myocardial infarction hemodynamic measurements by Swan-Ganz-Catheterization were performed before and after a 3-week therapy with a single dose of 120 mg ISDN in slow-release form. No patient received vasodilators and surgical revascularization was not indicated. Hemodynamics were measured before, 2 and 10 h after ISDN at rest and during exercise. Both before (rest/exercise: LVFP = 18.9 +/- 8.1 +/- 8.1/31.2 +/- 10.5 mmHg) and after 3 weeks (20.6 +/- 8.9/33.1 +/- 14.4 mmHg) ISDN significantly reduced LVFP 2 h (12.1 +/- 5.9/19.0 +/- 10.1 and 11.7 +/- 5.8/20.5 +/- 10.4 after 3 weeks) and 10 h (12.2 +/- 4.6/23.5 +/- 11.0 and 13.0 +/- 3.8/25.8 +/- 11.7 mmHg after 3 weeks) after application. No significant changes of heart rate were observed. In a subgroup of patients hemodynamic control after a 1-year treatment with 120 mg ISDN revealed a sustained reduction of LVFP at rest and during exercise. There is no significant evidence for the development of nitrate tolerance using this treatment regimen in chronic left heart failure.

Aged↗
PubMed1983

Assessment of sublingual isosorbide dinitrate and intracoronary nifedipine during ergonovine provocation.

In 37 patients with suspected vasospastic angina diagnostic ergonovine testing was used as a method of analysing the efficacy of sublingual ISDN in comparison with sublingual and intracoronary nifedipine on coronary luminal diameter, left ventricular ejection fraction, aortic blood pressure, heart rate and left ventricular end-diastolic pressure. 10 mg of sublingual ISDN counteracted the ergonovine effects on left ventricular pump function and hemodynamics. The luminal diameter of the epicardial coronary arteries increased from 3.5 +/- 0.8 to 4.9 +/- 0.8 mm. 20 mg of sublingual nifedipine did not change the coronary luminal diameter within 8-10 minutes after the ergonovine test. After administration of 0.1 mg of nifedipine into the right and left coronary artery the luminal diameters increased in the same range as after sublingual ISDN. Whereas the aortic blood pressure decreased after intracoronary nifedipine from 170 +/- 23 to 153 +/- 27 mmHg with a concomitant increase in heart rate, no effect on the left ventricular pump function could be assessed. In the model of ergonovine testing ISDN has shown itself as a potent drug in releasing the ergonovine effects. Sublingual ISDN is as potent as intracoronary nifedipine in releasing the ergonovine-induced reduction of coronary luminal diameters and more potent in counteracting the ergonovine effects concerning the cardiac pump function.

Adult↗