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Duration of Action of Pentaerythritol Trinitrate and Nitroglycerine: A Comparison Using Exercise Performance and Haemodynamic Alterations
Author(s) -
Vohra J.,
Baker G.,
Ross D.,
Hunt D.,
Sloman G.
Publication year - 1979
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1979.tb03394.x
Subject(s) - medicine , hemodynamics , anesthesia , placebo , pulmonary wedge pressure , angina , myocardial infarction , alternative medicine , pathology
Summary: The duration of action of pentaerythritol trinitrate (PTN), an organic nitrate for sublingual administration, was compared with that of nitroglycerine (NG) by exercise testing and haemodynamic measurements. A group of ten patients (exercise study A) with effort induced angina were exercised on a bicycle 15 and 45 minutes after double blind randomised administration of PTN, NG or a placebo. Each patient was exercised on three separate occasions and acted as his own control. The results showed that PTN was effective at 15 and 45 minutes (P = < 0.01 and <0.02) while NG was active at 15 minutes but not at 45 minutes (P = <0.01 and >0.05). Another group of nine patients (exercise study B) were exercised at 15, 45, 90 and 120 minutes and the exercise performance was significantly improved at 15, 45 minutes (P <0.01), it was better than NG at 90 minutes but did not reach statistical significance (P>0. 05) but did so at 120 minutes (P<0.02). The longer duration of action of PTN was further confirmed by haemodynamic measurements in 18 patients with chronic congestive cardiac failure who were treated with NG or PTN. The fall in mean right atrial (mRA) and mean pulmonary artery wedge (mPAW) pressure in patients treated with NG was maintained up to 30 minutes while patients who received PTN showed a fall in mPAW following PTN which lasted up to 120 minutes. We conclude that PTN has a significantly longer duration of action than NG and may have a place in treatment of patients with ischaemic heart disease and cardiac failure where longer acting sublingual nitrates are indicated.