[Pharmacodynamics of nitroglycerin for sublingual medication in ischemic heart disease]

The hemodynamic effect of sublingual nitroglycerin (0.5 mg) was studied in 113 patients with ischemic heart disease by means of tetrapolar finger rheoplethysmography and impedance-cardiography. A decrease in systemic arterial pressure, stroke and minute cardiac indices and ejection period, and increase in the rate of cardiac rhythm were found. In 8% of cases there was a negative reaction to nitroglycerin manifested by a marked drop in arterial pressure and increase in the rate of cardiac contractions. In 40% of patients a negative "after--effect" was recorded following cessation of the direct effect of nitroglycerin. The most informative index of the effect of nitroglycerin was its peripheral activity. According to the duration of the hemodynamic effect of a standard nitroglycerin dose, three groups of patients are distinguished.