POSSIBLE MECHANISMS OF NITRATE TOLERANCE

被引：8

作者：

ELKAYAM, U

MEHRA, A

SHOTAN, A

OSPRZEGA, E

机构：

[1] Department of Medicine, Division of Cardiology, University of Southern California (USC) Los Angeles, CA

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 1992年 / 70卷 / 17期

关键词：

D O I：

10.1016/0002-9149(92)90026-U

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Prolonged exposure to organic nitrates has been shown to lead to the rapid development of tolerance to the peripheral and coronary vasodilatory effects of these drugs. As a result of this phenomenon, the hemodynamic and anti-ischemic effects of nitrates may be rapidly attenuated in patients with ischemic heart disease, congestive heart failure, or both. This nitrate tolerance appears to be both dose- and time-dependent. Likely mechanisms proposed for its development are multifactorial and include depletion of sulfhydryl groups, a nitrate-mediated increase in blood volume, and neurohormonal stimulation with activation of vasoconstrictive mechanisms.

引用

收藏

页码：G49 / G54

页数：6

相关论文

共 37 条

[1]

AHLNER J, 1986, ACTA PHARMACOL TOX, V59, P17

[2] HEMODYNAMICS AND ANTIANGINAL EFFECTS OF HIGH DOSE ORAL ISOSORBIDE DINITRATE AFTER CHRONIC USE [J].

DANAHY, DT ;

ARONOW, WS .

CIRCULATION, 1977, 56 (02) :205-212

[3] EFFECTS OF NITROGLYCERIN AT THERAPEUTIC DOSES ON PLATELET-AGGREGATION IN UNSTABLE ANGINA-PECTORIS AND ACUTE MYOCARDIAL-INFARCTION [J].

DIODATI, J ;

THEROUX, P ;

LATOUR, JG ;

LACOSTE, L ;

LAM, JYT ;

WATERS, D .

AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (07) :683-688

[4] TOLERANCE TO INTRAVENOUS NITROGLYCERIN IN PATIENTS WITH CONGESTIVE-HEART-FAILURE - ROLE OF INCREASED INTRAVASCULAR VOLUME, NEUROHUMORAL ACTIVATION AND LACK OF PREVENTION WITH N-ACETYLCYSTEINE [J].

DUPUIS, J ;

LALONDE, G ;

LEMIEUX, R ;

ROULEAU, JL .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 16 (04) :923-931

[5]

ELBRIGHT GE, 1914, JAMA-J AM MED ASSOC, V10, P201

[6] GLYCERYL TRINITRATE (NITROGLYCERIN) OINTMENT AND ISOSORBIDE DINITRATE - A REVIEW OF THEIR PHARMACOLOGICAL PROPERTIES AND THERAPEUTIC USE [J].

ELKAYAM, U ;

ARONOW, WS .

DRUGS, 1982, 23 (03) :165-194

[7] RANDOMIZED STUDY TO EVALUATE THE RELATION BETWEEN ORAL ISOSORBIDE DINITRATE DOSING INTERVAL AND THE DEVELOPMENT OF EARLY TOLERANCE TO ITS EFFECT ON LEFT-VENTRICULAR FILLING PRESSURE IN PATIENTS WITH CHRONIC HEART-FAILURE [J].

ELKAYAM, U ;

ROTH, A ;

MEHRA, A ;

OSTRZEGA, E ;

SHOTAN, A ;

KULICK, D ;

JAMISON, M ;

JOHNSON, JV ;

RAHIMTOOLA, SH .

CIRCULATION, 1991, 84 (05) :2040-2048

[8] TOLERANCE TO ORGANIC NITRATES - EVIDENCE, MECHANISMS, CLINICAL RELEVANCE, AND STRATEGIES FOR PREVENTION [J].

ELKAYAM, U .

ANNALS OF INTERNAL MEDICINE, 1991, 114 (08) :667-677

[9] INCIDENCE OF EARLY TOLERANCE TO HEMODYNAMIC-EFFECTS OF CONTINUOUS INFUSION OF NITROGLYCERIN IN PATIENTS WITH CORONARY-ARTERY DISEASE AND HEART-FAILURE [J].

ELKAYAM, U ;

KULICK, D ;

MCINTOSH, N ;

ROTH, A ;

HSUEH, W ;

RAHIMTOOLA, SH .

CIRCULATION, 1987, 76 (03) :577-584

[10] THE EFFECTS OF ORGANIC NITRATES ON PROSTACYCLIN BIOSYNTHESIS AND PLATELET-FUNCTION IN HUMANS [J].

FITZGERALD, DJ ;

ROY, L ;

ROBERTSON, RM ;

FITZGERALD, GA .

CIRCULATION, 1984, 70 (02) :297-302

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