Nitrate tolerance in angina therapy: How to avoid it

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Tolerance is the attenuation, or loss, of one of several of the effects of organic nitrates after long term administration. All organic nitrate regimens using frequent doses of long-acting nitrates (3 or more times daily), continuous delivery systems [transdermal nitroglycerin (glyceryl trinitrate) patches or continuous intravenous infusions of nitroglycerin] or long-acting (sustained release) preparations will result in partial or complete nitrate tolerance. There are several proposed mechanisms which may contribute to the development of tolerance including activation of neurohormonal mechanisms, plasma volume expansion and depletion of intracellular sulfhydryl cofactors. To avoid tolerance to long term nitrate therapy, regimens should be tailored to provide a 10- to 12-hour nitrate-free interval when possible. This means that antianginal prophylaxis can only be provided by nitrate therapy for some portion of each day, and that some patients will develop an increase in angina in the nitrate-free intervals which will necessitate short term therapy with sublingual nitroglycerin or a similar preparation.

Original languageEnglish (US)
Pages (from-to)196-199
Number of pages4
JournalDrugs
Volume49
Issue number2
StatePublished - 1995

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Nitrates
Nitroglycerin
Therapeutics
Delayed-Action Preparations
Plasma Volume
Intravenous Infusions
Chemical activation
Plasmas

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Toxicology

Cite this

Nitrate tolerance in angina therapy : How to avoid it. / Rutherford, J. D.

In: Drugs, Vol. 49, No. 2, 1995, p. 196-199.

Research output: Contribution to journalArticle

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