Nitrates for Coronary Artery Disease

Table Of Content

INTRODUCTION1

Thesis Statements1

DISCUSSION1

Overview of drug class1

Common Generic/Trade Names2

Indications for nitrates2

Pharmacokinetics of Nitrates for coronary artery disease3

Contraindications to nitrates4

How to assign the nitrates in the clinic4

Pharmacodynamics: Mechanism of Action6

Adverse drug effects7

Discussion of relevant research regarding drug class9

Nitroglycerine9

Isosorbide dinitrate10

Isosorbide-5-mononitrate11

Special concern to the physical therapist12

Role of Physical Therapist in Pharmacological Management12

CONCLUSION14

REFERENCES15

Nitrates for Coronary Artery Disease

Introduction

Nitrates are among the oldest drugs used in cardiology. They are the only known means to effectively interrupt angina. Nitrates are a group of heart drugs, used primarily to relieve and prevent attacks of coronary artery disease. These drugs dilate blood vessels (vasodilators). Nitrates dilate coronary arteries and increase blood flow to the heart muscle. They also dilate the veins of the body; relieve the workload of the heart through temporarily reduce the volume of blood returning to the heart. This paper will focus on the Nitrates for Coronary Artery Disease and physical therapist special concern along with physical therapist in pharmacological management.

Thesis Statements

Nitrates occupy one of the main drugs in the drug treatment of coronary heart disease (CHD). These drugs have a pronounced anti-ischemic effect, through which they are able to arrest and prevent angina attacks, significantly improve patient tolerance of physical activity and improve quality of life.

Discussion

Overview of drug class

Nitrates are one of the “old” groups of drugs used in cardiology while nitroglycerin to relieve angina began to use in 1879. Nitrates have been used for a long time and it was only used in the form of dosage having a short duration of action (Abrams J. 2002). For the treatment of Angina, Nitrates can be used in three ways:

In order to relieve Angina, short term nitrates are taken bases on needed basis.

Short-term nitrates are also used before certain activities can cause an attack to angina.

In order to reduce the number of angina attack, long term nitrates are taken on daily basis.

Common Generic/Trade Names

Nitroglycerins are also available in capsule and tablets and also in patches which can place on the skin as a cream. For immediate relieve, this drug can be placed under the tongue or sprayed in the mouth (Healthwise Staff, 2010). The following are the Common Generic/Trade Names used for Coronary Artery Disease:

Generic Name

Brand Name

Isosorbide dinitrate

Dilatrate, Isordil

Isosorbide mononitrate

ISMO

Nitroglycerin

Nitro-Dur, Nitrolingual, Nitrostat

Indications for nitrates

Nitrates have a distinct anti-anginal, or more precisely, anti-ischemic effect, that is, the ability to prevent the appearance of myocardial ischemia or reduce this disease severity. Therefore, these drugs are used to treat all angina form i.e. unstable angina, stable angina and variant angina. Nitrates do not affect the course of coronary heart disease, so assign them prophylactically pointless. A number of studies (e.g., ISIS-4 - Fourth International Study of Infarct Survival) showed that nitrate had no influence on the prognosis of patient's life with a high risk of complications, such as in patients with myocardial infarction (Abrams J. 2002).

To improve the prognosis of life in these patients using other drugs, particularly ß-blockers. So far, there are no data as to whether the impact ...