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Related Concept Videos

Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

Rational Dosage Regimen: Maintenance Dose and Loading Dose

A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady state,...
Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...

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Related Experiment Video

Updated: Jul 15, 2026

Measuring Nitrite and Nitrate, Metabolites in the Nitric Oxide Pathway, in Biological Materials using the Chemiluminescence Method
08:25

Measuring Nitrite and Nitrate, Metabolites in the Nitric Oxide Pathway, in Biological Materials using the Chemiluminescence Method

Published on: December 25, 2016

When does nitrate tolerance develop? What dosages and which intervals are necessary to ensure maintained

W Rudolph1, J Dirschinger, G Reiniger

  • 1Department of Cardiology, German Heart Center, Munich.

European Heart Journal
|January 1, 1988
PubMed
Summary

Nitrate tolerance develops with continuous use, reducing effectiveness in treating angina. Interval treatment, with nitrate-free periods, maintains therapeutic effects for coronary artery disease patients.

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Chemiluminescence-based Assays for Detection of Nitric Oxide and its Derivatives from Autoxidation and Nitrosated Compounds
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Chemiluminescence-based Assays for Detection of Nitric Oxide and its Derivatives from Autoxidation and Nitrosated Compounds

Published on: February 16, 2022

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Long-term nitrate therapy for coronary artery disease (CAD) can lead to tolerance, diminishing anti-anginal and anti-ischemic effects.
  • Understanding nitrate tolerance mechanisms is crucial for optimizing treatment strategies in CAD management.

Purpose of the Study:

  • To investigate the development of tolerance to nitrates like isosorbide dinitrate (ISDN) and nitroglycerin (NTG) during chronic administration.
  • To evaluate the efficacy of interval nitrate treatment in circumventing tolerance and maintaining therapeutic benefits.

Main Methods:

  • Controlled studies involving sustained-release and non-sustained-release ISDN formulations at various dosages.
  • Assessment of transdermal NTG patches with different delivery rates (10, 15, 30 mg/24h).
  • Evaluation of interval treatment regimens incorporating nitrate-free periods.

Main Results:

  • Continuous ISDN and NTG administration resulted in tolerance, with attenuated or unaffected anti-ischemic effects.
  • Tolerance was linked to limited increases in plasma nitrate concentrations relative to baseline.
  • Interval treatment regimens (e.g., twice-daily ISDN, once-daily isosorbide 5-mononitrate, 12-hour NTG patch-free interval) maintained effectiveness.

Conclusions:

  • Nitrate tolerance is a significant issue in long-term CAD management, particularly with continuous dosing.
  • Interval treatment strategies effectively circumvent nitrate tolerance, preserving therapeutic efficacy.
  • While interval treatment enhances effectiveness, it may not provide 24-hour therapeutic coverage, necessitating further refinement of delivery systems.