Isosorbide Dinitrate) Tablets
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Comparison of the Antiischaemic and Antianginal Effects of Nicorandil and Amlodipine in Patients with Symptomatic Stable Angina Pectoris: the SWAN Study
Journal of Clinical and Basic Cardiology An Independent International Scientific Journal Journal of Clinical and Basic Cardiology 1999; 2 (2), 213-217 Comparison of the antiischaemic and antianginal effects of nicorandil and amlodipine in patients with symptomatic stable angina pectoris: the SWAN study The SWAN Study Group Homepage: www.kup.at/jcbc Online Data Base Search for Authors and Keywords Indexed in Chemical Abstracts EMBASE/Excerpta Medica Krause & Pachernegg GmbH · VERLAG für MEDIZIN und WIRTSCHAFT · A-3003 Gablitz/Austria ORIGINAL PAPERS, CLINICAL The SWAN study J Clin Basic Cardiol 1999; 2: 213 Comparison of the antiischaemic and antianginal effects of nicorandil and amlodipine in patients with symptomatic stable angina pectoris: the SWAN study The SWAN Study Group1 This multicentre, double-blind, randomised study compared the antiischaemic and antianginal effects of nicorandil and amlodipine in patients with symptomatic stable angina pectoris. Nicorandil is a new coronary and balanced peripheral vasodilating agent that operates through two mechanisms of action: activation of ATP-dependent K-channels and stimulation of guanylate cyclase. A total of 121 patients with symptomatic stable angina pectoris were randomised to receive nicorandil 10 mg twice daily (bd) or amlodipine 5 mg once daily (od) for 8 weeks (optional dosage increase after 2-4 weeks to 20 mg bd and 10 mg od, respec- tively). Symptom-limited exercise tolerance tests were performed at baseline, and after 2 and 8 weeks treatment, respectively. In addition, the number of anginal attacks, nitroglycerin (NTG) usage, blood pressure (BP), heart rate (HR) and adverse events were recorded, and a subjective assessment of quality of life performed. -
Tolerance and Resistance to Organic Nitrates in Human Blood Vessels
\ö-\2- Tolerance and Resistance to Organic Nitrates in Human Blood Vessels Peter Radford Sage MBBS, FRACP Thesis submit.ted for the degree of Doctor of Philosuphy Department of Medicine University of Adelaide and Cardiology Unit The Queen Elizabeth Hospital I Table of Gontents Summary vii Declaration x Acknowledgments xi Abbreviations xil Publications xtil. l.INTRODUCTION l.L Historical Perspective I i.2 Chemical Structure and Available Preparations I 1.3 Cellular/biochemical mechanism of action 2 1.3.1 What is the pharmacologically active moiety? 3 1.3.2 How i.s the active moiety formed? i 4 1.3.3 Which enzyme system(s) is involved in nitrate bioconversi<¡n? 5 1.3.4 What is the role of sulphydryl groups in nitrate action? 9 1.3.5 Cellular mechanism of action after release of the active moiety 11 1.4 Pharmacokinetics t2 1.5 Pharmacological Effects r5 1.5.1 Vascular effects 15 l.5.2Platelet Effects t7 1.5.3 Myocardial effects 18 1.6 Clinical Efhcacy 18 1.6.1 Stable angina pectoris 18 1.6.2 Unstable angina pectoris 2t 1.6.3 Acute myocardial infarction 2l 1.6.4 Congestive Heart Failure 23 ll 1.6.5 Other 24 1.7 Relationship with the endothelium and EDRF 24 1.7.1 EDRF and the endothelium 24 1.7.2 Nitrate-endothelium interactions 2l 1.8 Factors limiting nitrate efficacy' Nitrate tolerance 28 1.8.1 Historical notes 28 1.8.2 Clinical evidence for nitrate tolerance 29 1.8.3 True/cellular nitrate tolerance 31 1.8.3.1 Previous studies 31 | .8.3.2 Postulated mechanisms of true/cellular tolerance JJ 1.8.3.2.1 The "sulphydryl depletion" hypothesis JJ 1.8.3.2.2 Desensitization of guanylate cyclase 35 1 8.i.?..3 Impaired nitrate bioconversion 36 1.8.3.2.4'Ihe "superoxide hypothesis" 38 I.8.3.2.5 Other possible mechanisms 42 1.8.4 Pseudotolerance ; 42 1.8.4. -
Current Status of Local Penile Therapy
International Journal of Impotence Research (2002) 14, Suppl 1, S70–S81 ß 2002 Nature Publishing Group All rights reserved 0955-9930/02 $25.00 www.nature.com/ijir Current status of local penile therapy F Montorsi1*, A Salonia1, M Zanoni1, P Pompa1, A Cestari1, G Guazzoni1, L Barbieri1 and P Rigatti1 1Department of Urology, University Vita e Salute – San Raffaele, Milan, Italy Guidelines for management of patients with erectile dysfunction indicate that intraurethral and intracavernosal injection therapies represent the second-line treatment available. Efficacy of intracavernosal injections seems superior to that of the intraurethral delivery of drugs, and this may explain the current larger diffusion of the former modality. Safety of these two therapeutic options is well established; however, the attrition rate with these approaches is significant and most patients eventually drop out of treatment. Newer agents with better efficacy-safety profiles and using user-friendly devices for drug administration may potentially increase the long-term satisfaction rate achieved with these therapies. Topical therapy has the potential to become a first- line treatment for erectile dysfunction because it acts locally and is easy to use. At this time, however, the crossing of the barrier caused by the penile skin and tunica albuginea has limited the efficacy of the drugs used. International Journal of Impotence Research (2002) 14, Suppl 1, S70–S81. DOI: 10.1038= sj=ijir=3900808 Keywords: erectile dysfunction; local penile therapy; topical therapy; alprostadil Introduction second patient category might be represented by those requesting a fast response, which cannot be obtained by sildenafil; however, sublingual apomor- Management of patients with erectile dysfunction phine is characterized by a fast onset of action and has been recently grouped into three different may represent an effective solution for these 1 levels. -
Cardiovascular Drugs and Therapies NITRATES COMPARISON CHART
Cardiovascular Drugs and Therapies NITRATES COMPARISON CHART Isosorbide Generic Nitroglycerin Nitroglycerin Nitroglycerin Nitroglycerin Dinitrate Isosorbide Isosorbide Name Intravenous Patch Ointment Sublingual Sublingual Dinitrate 5-Mononitrate Trade Name TRIDIL, NITRODUR, NITROL NITROLINGUAL generics generics (for IMDUR, generics TRANSDERM- Pumpspray, immediate generics NITRO, RHO-NITRO release) MINITRAN, Pumpspray, SR: no longer TRINIPATCH NITROLINGUAL available Metered dose spray NITROSTAT sublingual tablet Dosage 100 mg/250 mL 0.2 mg/h 30 g/30 inches SL spray: SL tablet: 5mg Immediate SR tablet: Forms premixed bottle 0.4 mg/h ointment 0.4 mg/ dose release 60 mg SR - UHN 0.6 mg/h SL tablet: tablet: Note: 0.84 mL 0.8 mg/h 0.3 mg, 0.6 mg 10 mg *Non- alcohol per 100 mL 30 mg formulary at solution UHN 100 mcg/mL 200 mcg/mL 400 mcg/mL 10 mg/10 mL vial - UHN 50 mg/10 mL vial - UHN CARDIOVASCULAR PHARMACOTHERAPY HANDBOOK All contents copyright © University Health Network. All rights reserved Cardiovascular Drugs and Therapies NITRATES COMPARISON CHART Isosorbide Generic Nitroglycerin Nitroglycerin Nitroglycerin Nitroglycerin Dinitrate Isosorbide Isosorbide Name Intravenous Patch Ointment Sublingual Sublingual Dinitrate 5-Mononitrate Dosing Starting and 0.2 to 0.8 ½ inch to 1 inch SL spray: SL tablet: Immediate 60-240 mg SR Usual dose target doses mg/h once tid-qid; remove 0.4 mg prn; 5-10 mg q2-4h release: once daily range are determined daily. for 8-10 hours dose may be for prophylaxis 10-45 mg tid by clinical per 24-hour repeated after of acute angina on qid situation and 12-14 hour period; 5 minutes for schedule the number and patch-free response to interval e.g., ON 0600, total of 3 doses (e.g. -
MEDICATION GUIDE Adempas (A Dem Pahs) (Riociguat) Tablets Read This Medication Guide Before You Start Taking Adempas and Each Time You Get a Refill
MEDICATION GUIDE Adempas (a dem pahs) (riociguat) tablets Read this Medication Guide before you start taking Adempas and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your doctor about your medical condition or your treatment. What is the most important information I should know about Adempas? • Serious birth defects. • Adempas can cause serious birth defects if taken during pregnancy. • Females must not be pregnant when they start taking Adempas or become pregnant during treatment with Adempas. • Females who are able to get pregnant must have a negative pregnancy test before beginning treatment with Adempas, each month during treatment, and 1 month after you stop treatment with Adempas. Talk to your doctor about your menstrual cycle. Your doctor will decide when to do the tests, and order the tests for you depending on your menstrual cycle. • Females who are able to get pregnant are females who: • Have entered puberty, even if they have not started their period, and • Have a uterus, and • Have not gone through menopause (have not had a period for at least 12 months for natural reasons, or who have had their ovaries removed) • Females who are not able to get pregnant are females who: • Have not yet entered puberty, or • Do not have a uterus, or • Have gone through menopause (have not had a period for at least 12 months for natural reasons, or who have had their ovaries removed) Females who are able to get pregnant must use 2 acceptable forms of birth control, during treatment with Adempas and for 1 month after stopping Adempas because the medicine may still be in the body. -
The Availability of Organic Nitrates from Intravenous Administration Systems
THE AVAILABILITY OF ORGANIC NITRATES FROM INTRAVENOUS ADMINISTRATION SYSTEMS by Paul Adrian Cossum B.Sc., M.P.S. submitted in partial fulfilment of the requirements for the degree of Master of Pharmacy UNIVERSITY OF TASMANIA - HOBART JUNE 1981 SUMMARY Nitroglycerin aind isosorbide dinitrate are two drugs which are infused intravenously during the treatment of ischaemic heart disease. The availability of these two drugs in solutions infused from plastic infusion bags or glass infusion bottles through plastic giving sets has been investigated. During simulated infusions the concentration of nitroglycerin and isosorbide dinitrate appearing in the effluent of the • giving set tubing was found to be much less than the concentration of the drug solution initially contained in the plastic infusion bag or glass infusion bottle. It was found that each component of the plastic infusion equipment sorbed the drugs to a significant extent and that the rate of disappearance of drugs from solutions stored in each component was in the rank order: giving set tubing > giving set burette > plastic infusion bag. There was no significant loss of either drug from solutions stored in glass bottles. The influence of formulation factors and storage conditions on the sorption of nitroglycerin, isosorbide dinitrate and another organic nitrate compound., ethylene glycol dinitrate, by plastic infusion equipment was studied. The extent of loss during simulated infusions was also found to be dependent on flow rate of drug solution through the giving set. The sorption of nitroglycerin and isosorbide dinitrate has clinical and pharmacokinetic significance. Losses of nitroglycerin and isosorbide dinitrate associated with their infusion through plastic Lnfusion equipment were minimised by infusing drug solutions from a glass syringe through high density polyethylene tubing. -
Use of Sildenafil in Patients with Cardiovascular Disease
Arq Bras Cardiol GuimarãesReview et al volume 73, (nº6), 1999 Sildenafil in patients with cardiovascular disease Use of Sildenafil in Patients with Cardiovascular Disease Armênio Costa Guimarães, Marcus Vinícius Bolívar Malachias, Otávio Rizzi Coelho, Emílio Cesar Zilli, Rafael Leite Luna Introduction of phosphodiesterase inhibitors. The erectile action of sildenafil combines increase in arterial flow with reduction Erectile dysfunction, formerly called impotence, is the in the venous flow of cavernous body of penis. Sildenafil inability of the male to achieve or maintain penile erection and leads to relaxation of smooth muscle of penile arteries and thus engage in coitus1. It is common among patients with trabeculae surrounding the sinusoidal spaces, resulting in cardiovascular diseases or their risk factors. This dysfunc- a greater engorgement of cavernous body. The trabeculae tion occurs mainly among individuals with coronary artery of engorged sinusoidal spaces compress the penile disease, after episodes of acute ischemic syndrome, hyper- venules against the tunica albuginea, reducing venous tensive patients underpharmacologic treatment, and among flow, contributing to maintenance of engorgement of patients with heart failure. In approximately 85% of these ca- cavernous body8. Relaxation of this smooth muscle ses, the fear of a cardiac event during coitus constitutes an results from a decrease in intracellular calcium mediated important factor for erectile dysfunction 2-4. by accumulation of the second messenger, the cyclic Discovery of sildenafil citrate has represented a great de- guanosine monophosphate (cGMP), whose production velopment in the treatment of erectile dysfunction; it may results from activation of guanyl cyclase by nitric oxide benefit, among many others, those patients with cardiovascu- produced by the stimulus of endothelial cells generated lar diseases or with their risk factors 5. -
Sgc Stimulators for Heart Failure: a Meta-Analysis of Randomized Controlled Trials
sGC Stimulators for Heart Failure: A Meta-Analysis of Randomized Controlled Trials Xueli Shi First Aliated Hospital of Chongqing Medical University Xuejing Yu University of Utah School of Medicine Jinhui Wang First Aliated Hospital of Chongqing Medical University Jianzhong Zhou ( [email protected] ) First Aliated Hospital of Chongqing Medical University Research Article Keywords: Heart failure, sGC stimulators, Vericiguat, Riociguat Posted Date: December 9th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-116054/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License OriginalsGC StimulatorsResearch for Heart Failure: A Meta-Analysis of Randomized Controlled Trials Xueli Shi, MM *, 1, Xuejing Yu, MD *, 2, Jinhui Wang, MM 1, Jianzhong Zhou, MM **, 1 1 Division of Cardiology, Department of Internal Medicine, The First Affiliated Hospital of Chongqing Medical University. #1 Yuanjiagang Youyi Road, Yuzhong District, Chongqing, China. 400016 2 University of Utah School of Medicine, Cardiothoracic Surgery Department, 15 N. #Medical Drive Room 5520, Salt Lake City, UT, USA, 84112-5650 Xueli Shi, ORCID 0000-0002-1467-4343 [email protected] Xuejing Yu [email protected] Jinhui Wang [email protected] Jianzhong Zhou [email protected] * Contributed equally ** Corresponding author 1 / 18 Abstract Background Oral sGC stimulators are novel treatments for heart failure (HF). Since individual studies are limited to confirm the efficacy and safety of sGC stimulators in patients with HF, we provide a meta-analysis based on published clinical randomized controlled trials. Methods Embase, PubMed, Cochrane and Medline were applied to search for randomized controlled trials (published before March 29, 2020 without language restrictions) by comparing oral sGC stimulators to placebos. -
REVATIO (Sildenafil Citrate) – Product Monograph Page 52 of 55 PART
IMPORTANT: PLEASE READ PART III: CONSUMER INFORMATION o nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in PrREVATIO® the mouth) (sildenafil tablets, Upjohn Standard) o isosorbide mononitrate and isosorbide dinitrate 20 mg sildenafil as (sildenafil citrate) (tablets that are swallowed, chewed, or dissolved in the mouth) (sildenafil injection, Upjohn Standard) If you are not sure if any of your medicines contain nitrates, 0.8 mg/mL sildenafil as (sildenafil citrate) or if you do not understand what nitrates are, ask your doctor or pharmacist. If you take REVATIO with any nitrate- READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR containing medicine or any nitrate, your blood pressure could MEDICINE. suddenly drop to a life-threatening level. You could get Read this carefully before you start taking REVATIO and each dizzy, faint, or even have a heart attack or stroke. time you get a refill. This leaflet is a summary and will not tell have loss of vision in one or both eyes from an eye disease you everything about this drug. Talk to your healthcare called non-arteritic anterior ischaemic optic neuropathy professional about your medical condition and treatment and ask (NAION) if there is any new information about REVATIO. ® take drugs like ketoconazole (Nizoral ), itraconazole (Sporanox®), ritonavir (Kaletra®) ABOUT THIS MEDICATION have pulmonary hypertension secondary to sickle cell anaemia (abnormality of the red blood cells) What the medication is used for: have severe liver disease REVATIO (sildenafil citrate) is used to treat pulmonary arterial have a recent history of stroke or heart attack or life- hypertension (high blood pressure in the blood vessels between the threatening arrhythmia (a heart rhythm disorder) heart and the lungs) in adults (18 years of age or older). -
Treatment of Children with Pulmonary Hypertension. Expert Consensus Statement on the Diagnosis and Treatment of Paediatric Pulmonary Hypertension
Pulmonary vascular disease ORIGINAL ARTICLE Heart: first published as 10.1136/heartjnl-2015-309103 on 6 April 2016. Downloaded from Treatment of children with pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK Georg Hansmann,1 Christian Apitz2 For numbered affiliations see ABSTRACT administration (oral, inhaled, subcutaneous and end of article. Treatment of children and adults with pulmonary intravenous). Additional drugs are expected in the Correspondence to hypertension (PH) with or without cardiac dysfunction near future. Modern drug therapy improves the Prof. Dr. Georg Hansmann, has improved in the last two decades. The so-called symptoms of PAH patients and slows down the FESC, FAHA, Department of pulmonary arterial hypertension (PAH)-specific rates of clinical deterioration. However, emerging Paediatric Cardiology and medications currently approved for therapy of adults with therapeutic strategies for adult PAH, such as Critical Care, Hannover PAH target three major pathways (endothelin, nitric upfront oral combination therapy, have not been Medical School, Carl-Neuberg- fi Str. 1, Hannover 30625, oxide, prostacyclin). Moreover, some PH centres may use suf ciently studied in children. Moreover, the com- Germany; off-label drugs for compassionate use. Pulmonary plexity of pulmonary hypertensive vascular disease [email protected] hypertensive vascular disease (PHVD) in children is (PHVD) in children makes the selection of appro- complex, and selection of appropriate therapies remains priate therapies a great challenge far away from a This paper is a product of the fi writing group of the European dif cult. In addition, paediatric PAH/PHVD therapy is mere prescription of drugs. -
Polyethylene Terephthalate (PET) Sheet from Korea and Oman
Polyethylene Terephthalate (PET) Sheet from Korea and Oman Investigation Nos. 731-TA-1455 and 731-TA-1457 (Final) Publication 5111 September 2020 U.S. International Trade Commission Washington, DC 20436 U.S. International Trade Commission COMMISSIONERS Jason E. Kearns, Chair Randolph J. Stayin, Vice Chair David S. Johanson Rhonda K. Schmidtlein Amy A. Karpel Staff assigned Kristina Lara, Investigator Jennifer Catalano, Industry Analyst Amelia Preece, Economist Emily Kim, Accountant Mara Alexander, Statistician Jason Miller, Attorney Elizabeth Haines, Supervisory Investigator Address all communications to Secretary to the Commission United States International Trade Commission Washington, DC 20436 U.S. International Trade Commission Washington, DC 20436 www.usitc.gov Polyethylene Terephthalate (PET) Sheet from Korea and Oman Investigation Nos. 731-TA-1455 and 731-TA-1457 (Final) Publication 5111 September 2020 CONTENTS Page Determinations ............................................................................................................................. 1 Views of the Commission ............................................................................................................. 3 Introduction ................................................................................................................ I‐1 Background ............................................................................................................................. I‐1 Statutory criteria .................................................................................................................... -
Isosorbide, a Plant-Based Feedstock for Coatings
Date: November 5, 2020 Introducing isosorbide: a sustainable, safe, high performance, plant-based feedstock for coatings Better resistance to UV, to abrasion, to scratching and impact. Better adhesion and improved properties for water-based formulation. The demands on today’s coatings, adhesives, sealants and elastomers (CASE) create a long list of desirable properties for a ‘would be’ feedstock. Step forward isosorbide. Perfectly safe and produced from an annually renewable feedstock isosorbide has a unique combination of properties that offers excellent potential for a range of CASE applications. What is isosorbide and how is it made? Isosorbide is a plant starch-derived bicyclic diol with rich functionality for a range of applications in the packaging, coating, adhesives, sealents and elastomers (CASE), and automotive sectors. Isosorbide is a bicyclic diol derived from plant starch. The schematic below illustrates how isosorbide is made. Starch from annually renewable feedstocks is hydrolysed to produce glucose which is then converted to sorbitol and on to isosorbide by hydrogenation. Over the last two decades, Roquette, the world’s leading manufacturer of isosorbide has refined and optimised this manufacturing route to produce stable, high purity isosorbide in industrial quantities. The company’s flagship plant produces isosorbide of three different grades, each tailored to specific industrial applications. Isosorbide is industrially manufactured from renewable plant feedstocks in a series of different grades. As a plant-based, sustainable feedstock with a carbon footprint of just 0.09 kg CO2/kg of product, isosorbide is an attractive substitute for monomers such as bisphenol A, which has a carbon footprint around 60 times higher.* However, impressive environmental credentials are just the start.