Nitroglycerin patches - do they work?
Article Abstract:
Organic nitrates given orally and transdermal nitroglycerin patches, which deliver the drug through the skin, are used to prevent and treat angina, or chest pain associated with myocardial ischemia, the insufficient supply of blood to the heart. Nitroglycerin-containing patches, which look like adhesive bandages, are often attached to the precordium, the skin area on the chest overlying the heart. Oral organic nitrates and nitroglycerin patches are long-acting, but become less effective with continued use. In one study, 562 patients with angina received 15-milligram (mg) nitroglycerin patches for the first week, and continued with the same dose or increasing doses of nitroglycerin ranging from 30 to 105 mg daily. Nitroglycerin patches prevented the development of angina due to treadmill exercise during the first four hours, but were ineffective after 24 hours despite increasing doses. Oral isosorbide dinitrate is usually given three times daily and at bedtime, but when the bedtime dose was omitted, it maintained its effectiveness for one week. Similarly, with overnight 10 or 12 hour patch-free intervals, nitroglycerin patches retain their effectiveness for one week. Another study involving 206 patients revealed that nitroglycerin patches used for only 12 hours during the day were effective in preventing and treating angina at doses of 10 mg or more. Nitroglycerin patches rapidly lose their effectiveness in treating angina if left on for 24 hours, even if they are re-applied with increasing doses. Patches consisting of 10 mg or more of nitroglycerin are effective if they are removed for 10 to 12 hours daily. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1989
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Bepridil for angina pectoris
Article Abstract:
Bepridil is a new calcium-channel blocking agent that is chemically unrelated to other drugs with this action, such as verapamil or nifedipine. Bepridil is recommended for use only in patients with angina (chest pain resulting from impaired blood flow to the heart) that is unresponsive to other agents, or for those who are intolerant of these drugs. Bepridil blocks a variety of calcium channels, unlike other blockers whose effects may be restricted. Bepridil either improves regional blood flow within the heart or favorably affects distribution of blood flow during exercise. Resting heart rate and blood pressure decrease by up to 6 percent, decreasing the heart's consumption of oxygen. The drug is well absorbed; most of the agent binds to plasma proteins. Peak levels are reached within two hours when multiple doses are given. Bepridil is chiefly metabolized in the liver, with metabolites excreted in urine. The drug has a longer half-life than other calcium blockers. In several studies, bepridil was better than other calcium blockers in relieving anginal pain and improving patient function. It also enhanced patient function when given with propranolol, a beta-blocker. Side effects of bepridil include dizziness, nausea, indigestion, headache, tremor, diarrhea, and nervousness. Agranulocytosis (severe decrease in white blood cells) and changes in heart rhythm, some serious, have also occurred. Because of these side effects, it is recommended for restricted use as described. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Testosterone patches for hypogonadism
Article Abstract:
Use of transdermal testosterone patches by men with hypogonadism appears to produce blood testosterone levels similar to that seen in normal young men. Hypogonadism is characterized by a decrease in blood testosterone levels and may be caused by Klinefelter's syndrome, toxic chemicals, decreased pituitary function, or HIV infection. The transdermal testosterone patches Testoderm and Androderm both appear to produce normal testosterone levels that are more stable than those produced with testosterone injections. Testoderm patches are applied to the relatively thin skin of the scrotum, where the presence of a certain enzyme that converts testosterone to dihydrotestosterone (DHT) produces abnormally high levels of DHT. The effects of high DHT levels over long time periods is not known. Androderm patches may be applied to the thicker skin of the arms, legs, abdomen and back. Androderm patches, which contain substances that enhance testosterone absorption, have been associated with more skin irritability and rashes than the Testoderm patches.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1996
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