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A practical guide to nitrate use.

K A Anderson1

  • 1Parkview Internal Medicine Associates, St. Paul.

Postgraduate Medicine
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

Nitrate medications effectively treat heart conditions like angina and heart failure. To prevent tolerance, a 10-12 hour nitrate-free interval is recommended, especially with transdermal patches, and lower doses may be needed for elderly patients.

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Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Nitrate preparations are established treatments for various cardiovascular conditions.
  • Understanding nitrate tolerance and its management is crucial for effective therapy.

Purpose of the Study:

  • To outline the therapeutic applications of nitrate preparations.
  • To provide guidance on managing nitrate tolerance.
  • To address specific considerations for elderly patients.

Main Methods:

  • Review of established clinical practices and pharmacological principles regarding nitrate use.
  • Analysis of tolerance development and management strategies.
  • Consideration of pharmacokinetic and pharmacodynamic factors in different patient populations.

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Main Results:

  • Nitrates are effective for acute and chronic angina, congestive heart failure, and myocardial infarction.
  • A nitrate-free interval of 10-12 hours is the preferred method to manage tolerance.
  • Elderly patients may require dose adjustments to prevent hypotension.

Conclusions:

  • Strategic administration of nitrates, including a daily nitrate-free interval, optimizes their therapeutic efficacy.
  • Careful dosing is essential, particularly in the elderly, to maximize benefits and minimize adverse effects like hypotension.