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Related Concept Videos

Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...

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

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

American heart journal·1999
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Congenital arteriovenous fistula of internal thoracic artery: successfully managed by transcatheter embolization.

Catheterization and cardiovascular diagnosis·1998
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Nitrate therapy for stable angina pectoris.

The New England journal of medicine·1998
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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
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The effect of hydralazine on the development of tolerance to continuous nitroglycerin.

The Journal of pharmacology and experimental therapeutics·1997
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Nitrate tolerance--problems both new and old.

The Canadian journal of cardiology·1996

Related Experiment Video

Updated: Jul 2, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

Antianginal efficacy of a new nitroglycerin patch.

J O Parker1

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

European Heart Journal
|May 1, 1989
PubMed
Summary

A new nitroglycerin (GTN) patch effectively treats exercise-induced angina by improving exercise performance. This sustained effect, achieved through a biphasic release, helps avoid nitrate tolerance during daily therapy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Exercise-induced angina pectoris is a common cardiovascular condition.
  • Nitroglycerin (GTN) is a standard treatment, but nitrate tolerance can limit its long-term efficacy.

Purpose of the Study:

  • To evaluate the efficacy and tolerance of a novel biphasic nitroglycerin (GTN) patch in patients with chronic, stable exercise-induced angina pectoris.
  • To assess the acute and sustained therapeutic effects of the GTN patch designed to mitigate nitrate tolerance.

Main Methods:

  • A placebo-controlled, double-blind study involving sixteen patients with exercise-induced angina.
  • Administration of two GTN patches (7.5 mg each) with a biphasic release profile designed for a 12-hour therapeutic window and a subsequent low-nitrate period.
  • Assessment of systolic blood pressure, heart rate, and exercise duration to angina endpoint (P2) at various time points.

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Main Results:

  • The active GTN patches significantly decreased systolic blood pressure and increased heart rate upon initial application.
  • Exercise duration to moderate angina (P2) was significantly increased at 4 and 8 hours during acute therapy.
  • Similar improvements in exercise duration were observed during sustained, once-daily therapy, indicating maintained efficacy.

Conclusions:

  • The novel biphasic GTN patch demonstrates efficacy in improving exercise performance in patients with exercise-induced angina.
  • The unique release profile of the Biophase GTN patch appears to prevent or delay the onset of nitrate tolerance during sustained daily use.