1983 Volume 14 Issue 4 Pages 649-654
Evaluation was made on central hemodynamic effects of isosorbide dinitrate (ISDN) spray (Isomack spray®, Heinlich Mack Nachf., Germany) with special refference to the onset and duration of action compared to sublingual nitroglycerin and ISDN.
In nine patients with uncomplicated acute myocardial infarction, ISDN spray (2 sprays, 2.5 mg), nitroglycerin (TNG, 0.3 mg) and ordinary ISDN tablet (5mg) were administered by single-blind cross-over method under hemodynamic monitoring with Swan-Ganz catheter. Systolic pulmonary artery pressure (s-PA), systolic blood pressure (s-BP) measured by sphyngomanometry and heart rate were measured. every one minute for 10 min, every 5 min for next 20 min and every 15 to 30 min thereafter up to 120 min. Using s-PA as an index for nitrate action, the onset and duration of the effect as well as the extent of the changes were compared among these three drugs.
ISDN spary had quick onset of action (2.67±2.4min, mean±SD) which was comparable with TNG (2.67±1.00 min), while ISDN spray had long duration of action (57.4±42.1 min) which was comparable with sublingual ISDN (85.6±39.5, ns) and was significantly longer than TNG (11.4±6.4 min, P<0.05). ISDN spray (2.5mg) showed same extent of hemodynamic changes as 0.3 mg of TNG and 5 mg of ISDN. It is concluded that ISDN spray is a useful agent for the abortion of anginal attacks by its quick onset and long duration of action.
