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Intravenous Nitroglycerin Tolerance in Patients with Ischemic Cardiomyopathy and Congestive Heart Failure
Author(s) -
Earl Grace L.,
Stanek Eric J.,
Spinier Sarah A.
Publication year - 1998
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1998.tb03840.x
Subject(s) - medicine , heart failure , nitroglycerin (drug) , ischemic cardiomyopathy , angina , heart transplantation , cardiology , ischemia , cardiomyopathy , anesthesia , ejection fraction , myocardial infarction
A daily nitrate‐free interval (NFI) lasting 4–7 hours was instituted in four patients with severe congestive heart failure secondary to myocardial ischemia who were awaiting orthotopic heart transplantation. The duration of intravenous nitroglycerin therapy ranged from 14–55 days, and the maximum dosage was 50–400 μg/minute. Anginal events occurred more frequently during the NFI than during intravenous therapy. An NFI of 8–12 hours reduces tolerance in patients with congestive heart failure and stable angina. However, the experience in these patients with recurrent ischemia does not support its use to prevent ischemic events during hospitalization.