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[Controlled clinical studies of tolerance development and dosing problems in nitrate therapy]
Herz
|June 1, 1996
Summary
Tolerance to organic nitrates, like nitroglycerine, can be overcome by incorporating nitrate-free intervals. This strategy ensures sustained anti-ischaemic and haemodynamic effects, crucial for effective therapy.
Area of Science:
- Pharmacology
- Cardiology
Context:
- Tolerance to organic nitrates is a well-documented clinical issue.
- Continuous nitrate administration can lead to diminished therapeutic effects.
Purpose:
- To discuss the clinical problem of nitrate tolerance.
- To highlight the importance of nitrate-free intervals for maintaining therapeutic efficacy.
Summary:
- Continuous application, short dosing intervals, and high doses of organic nitrates contribute to tolerance.
- A nitrate-free interval of 12–18 hours allows for sustained haemodynamic and anti-ischaemic effects.
- This approach ensures therapeutic benefits for at least 8–12 hours, though protection may be lacking during the interval.
Impact:
- Understanding nitrate tolerance is essential for optimizing anti-ischaemic and heart failure therapy.
- Implementing nitrate-free intervals can improve patient outcomes by ensuring consistent therapeutic effects.
- This strategy addresses the challenge of achieving continuous relief with organic nitrates.