Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Nitrate tolerance in angina pectoris.

J O Parker1

  • 1Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Cardiovascular Drugs and Therapy
|January 1, 1989
PubMed
Summary

Tolerance to organic nitrates can be overcome by incorporating nitrate-free periods into dosing schedules. This strategy ensures continued efficacy of organic nitrates, preventing tolerance development during therapy.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

ARCTIC: assessment of haemodynamic response in patients with congestive heart failure to telmisartan: a multicentre dose-ranging study in Canada.

American heart journal·1999
Same author

Congenital arteriovenous fistula of internal thoracic artery: successfully managed by transcatheter embolization.

Catheterization and cardiovascular diagnosis·1998
Same author

Nitrate therapy for stable angina pectoris.

The New England journal of medicine·1998
Same author

Cardiovascular death and left ventricular remodeling two years after myocardial infarction: baseline predictors and impact of long-term use of captopril: information from the Survival and Ventricular Enlargement (SAVE) trial.

Circulation·1997
Same author

The effect of hydralazine on the development of tolerance to continuous nitroglycerin.

The Journal of pharmacology and experimental therapeutics·1997
Same author

Nitrate tolerance--problems both new and old.

The Canadian journal of cardiology·1996

Area of Science:

  • Cardiovascular Pharmacology
  • Pharmacology
  • Drug Efficacy

Background:

  • Organic nitrates are crucial for managing angina but rapidly lose efficacy due to tolerance.
  • Continuous dosing strategies aiming for 24-hour therapeutic plasma nitrate levels are linked to tolerance development.
  • Tolerance impacts hemodynamic and antianginal effects of organic nitrates.

Purpose of the Study:

  • To investigate dosing strategies that prevent tolerance to organic nitrates.
  • To determine if nitrate-free intervals can maintain the efficacy of organic nitrates.
  • To explore methods for overcoming nitrate tolerance.

Main Methods:

  • Review of existing literature on nitrate tolerance and dosing.
  • Analysis of different nitrate preparations (oral, buccal, transdermal).
  • Examination of various dosing schedules and their impact on nitrate levels and efficacy.

Main Results:

  • Dosing schedules with a nitrate-free period prevent tolerance development.
  • Oral isosorbide dinitrate requires approximately a 12-hour nitrate-free interval.
  • Buccal nitroglycerin and daily patch removal show potential for preventing tolerance.
  • Intermittent dosing may be sufficient to maintain therapeutic effects without tolerance.

Conclusions:

  • Incorporating nitrate-free periods is a viable strategy to maintain organic nitrate efficacy.
  • Optimizing dosing intervals can prevent tolerance and ensure sustained antianginal benefits.
  • Further research is needed to define optimal nitrate-free periods for different preparations.

Related Experiment Videos