0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Transdermal Nitroglycerin Patches in Angina Pectoris: Dose Titration, Duration of Effect, and Rapid Tolerance

UDHO THADANI, M.B.B.S., M.R.C.P., F.R.C.P.(C); STEPHEN F. HAMILTON, Pharm.D.; EDWIN OLSON, M.D.; JEROME ANDERSON, M.D.; WYATT VOYLES, M.D.; RAJESH PRASAD, M.D.; and STEPHEN M. TEAGUE, M.D.
[+] Article and Author Information

Presented in part in November 1985 at the 58th annual meeting of the American Heart Association, Washington, D.C.

▸Requests for reprints should be addressed to Udho Thadani, M.B.B.S.; Division of Cardiology, University of Oklahoma Health Sciences Center, P.O. Box 26901; Oklahoma City, OK 73190.


Oklahoma City, Oklahoma


©1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;105(4):485-492. doi:10.7326/0003-4819-105-4-485
Text Size: A A A

The duration of effect of transdermal nitroglycerin patches was studied in 14 patients with angina pectoris. By titrating the dose to achieve specific circulatory effects, we chose a patch size that produced a consistent fall in systolic blood pressure of 10 mm Hg or greater for each patient (10 cm2 in 7 patients, 20 cm2 in 5, and 40 cm2 in 2; releasing 5, 10, and 20 mg of nitroglycerin per 24 hours, respectively). The effects of these individualized patches were compared with those of placebo patches. Compared with placebo, nitroglycerin patches increased exercise duration to the onset of angina (257 ±72 compared with 383 ±130 seconds, p < 0.0001) and total exercise time (338 ±89 compared with 456 ±119 seconds, p < 0.0001) and decreased ST segment depression (1.0 ±0.5 compared with 0.6 ±0.4 mm, p < 0.05) at 4 hours but not at 24 and 48 hours. We conclude that nitroglycerin patches do not show objective evidence of antianginal or antiischemic effects for 24 hours. Tolerance to the circulatory and antianginal effects probably develops within 24 hours of patch application.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)