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Related Concept Videos

Crossover Experiments01:16

Crossover Experiments

Crossover experiments, also called the repeated-measurements design, is a study design in which all experimental units are exposed to all treatments in different periods. Crossover experiments are generally used in psychology, the pharmaceutical industry, agriculture, and medicine.
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.
Blinding01:11

Blinding

Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.
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...
Drug Delivery: Enteral Route01:18

Drug Delivery: Enteral Route

The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
Drugs in...
Oral Drug Delivery Systems: Continuous-Release Systems01:26

Oral Drug Delivery Systems: Continuous-Release Systems

Continuous-release drug delivery systems offer a strategic approach to maintaining therapeutic drug levels over extended periods following oral administration. By modulating the release rate of active pharmaceutical ingredients, these systems minimize fluctuations in plasma concentrations, which enhances clinical efficacy and reduces the need for frequent dosing. Such characteristics make them particularly advantageous in managing chronic diseases where patient adherence and stable drug...
Transdermal Drug Delivery Systems01:18

Transdermal Drug Delivery Systems

Transdermal drug delivery systems (TDDS) enable the controlled release of drugs across the skin into systemic circulation. They are particularly advantageous for drugs with short half-lives or narrow therapeutic indices, as they maintain consistent plasma concentrations and reduce the risk of subtherapeutic or toxic levels.TDDS are categorized into monolithic, reservoir, and mixed systems. Monolithic systems embed the drug in a polymer matrix, where diffusion governs release. Reservoir systems...

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A double-blind multiple crossover trial evaluating a transdermal nitroglycerin system vs placebo.

K Dickstein, H Knutsen

    European Heart Journal
    |January 1, 1985
    PubMed
    Summary

    Transdermal nitroglycerin system (TNS) effectively reduced angina attacks and nitroglycerin use in patients with effort-induced angina at higher doses (≥20 cm²). Lower doses (10 cm²) showed no significant benefit, and tolerance may develop with TNS therapy.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Angina pectoris on effort is a common condition characterized by chest pain during physical activity.
    • Transdermal nitroglycerin system (TNS) is a potential treatment option for managing angina symptoms.

    Purpose of the Study:

    • To evaluate the efficacy and safety of transdermal nitroglycerin system (TNS) in patients with angina pectoris on effort.
    • To compare the effects of different TNS dosages against a placebo.

    Main Methods:

    • A 28-day, double-blind, multi-crossover study involving 56 patients with angina pectoris on effort.
    • Patients received varying dosages of TNS (10 cm² to 60 cm²) or placebo.
    • Data collected included daily anginal attack frequency, sublingual nitroglycerin use, and patient-reported outcomes via visual analog scale.

    Main Results:

    • Patients using higher TNS dosages (≥20 cm²) showed significant reductions in daily anginal attacks (1.4 vs. 2.5, P < 0.0001) and sublingual nitroglycerin requirements (2.3 vs. 3.6, P < 0.0001) compared to placebo.
    • No significant improvement was observed in patients using lower TNS dosages (10 cm²).
    • Evidence suggests the development of tolerance to TNS therapy over the study period.

    Conclusions:

    • Higher doses of transdermal nitroglycerin system (TNS) demonstrate efficacy in managing effort-induced angina pectoris.
    • Lower TNS dosages may not provide significant therapeutic benefits.
    • Further research is warranted to investigate potential tolerance development and rebound effects associated with TNS therapy.