dynamin


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isosorbide mononitrate

Angeze (UK), Chemydur (UK), Cibral (UK), Cibral XL (UK), Dynamin (UK), Dynamin XL (UK), Elantan (UK), Elantan LA (UK), Imazin XL (UK), Imdur (UK), Imo LA (UK), Isib (UK), ISMO (UK), Isodur (UK), Ketanodur (UK), Modisal (UK), Monigen (UK), Monigen XL (UK), Monit (UK), Monit LS (UK), Monoket (UK), Monomax (UK), Monomax SR (UK), Monomax XL (UK), Monomil (UK), Monosorb (UK), Trangina (UK), Trangina XL (UK), Xismox (UK), Zemon (UK), Zemon XL (UK)

Pharmacologic class: Nitrate

Therapeutic class: Antianginal

Pregnancy risk category C

Action

Promotes peripheral vasodilation and reduces preload and afterload, decreasing myocardial oxygen consumption and increasing cardiac output. Also dilates coronary arteries, increasing blood flow and improving collateral circulation.

Availability

isosorbide dinitrate

Capsules: 40 mg

Capsules (extended-release): 40 mg

Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

Tablets (chewable): 5 mg, 10 mg

Tablets (extended-release): 20 mg, 40 mg

Tablets (sublingual): 2.5 mg, 5 mg, 10 mg

isosorbide mononitrate

Tablets: 10 mg, 20 mg

Tablets (extended-release): 30 mg, 60 mg, 120 mg

Indications and dosages

Treatment and prophylaxis in situations likely to provoke acute angina pectoris

Adults: 2.5 to 5 mg S.L. May repeat dose q 5 to 10 minutes for a total of three doses in 15 to 30 minutes.

Prophylaxis of angina pectoris

Adults: 5 to 40 mg P.O. (dinitrate conventional tablets) two to three times daily. Or 5 to 20 mg (mononitrate conventional tablets) b.i.d. Or 30 to 60 mg (mononitrate extended-release tablets) once daily. After several days, dosage may be increased to 120 mg (given as single 120-mg tablet or two 60-mg tablets) once daily. Rarely, 240 mg/day (mononitrate extended-release tablets) may be needed.

Off-label uses

• Heart failure

Contraindications

• Hypersensitivity to drug
• Severe anemia
• Acute myocardial infarction
• Angle-closure glaucoma
• Concurrent sildenafil therapy

Precautions

Use cautiously in:
• head trauma, volume depletion
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Give oral form 30 minutes before or 1 to 2 hours after a meal. Make sure patient swallows tablets or capsules whole.
• Have patient wet S.L. tablet with saliva before placing it under tongue. To avoid tingling sensation, have him place tablet in buccal pouch.

Adverse reactions

CNS: dizziness, headache, apprehension, asthenia, syncope

CV: orthostatic hypotension, tachycardia, paradoxical bradycardia, rebound hypertension

EENT: sublingual burning (with S.L. route)

GI: nausea, vomiting, dry mouth, abdominal pain

Skin: flushing

Interactions

Drug-drug.Aspirin: increased isosorbide blood level and effects

Beta-adrenergic blockers, calcium channel blockers, phenothiazines: additive hypotension

Dihydroergotamine: antagonism of dihydroergotamine effects

Sildenafil: severe and potentially fatal hypotension

Drug-diagnostic tests.Cholesterol: decreased level

Methemoglobin, urine vanillylmandelic acid: increased levels

Patient monitoring

• Monitor ECG and vital signs closely, especially blood pressure.

In suspected overdose, assess for signs and symptoms of increased intracranial pressure.
• Monitor arterial blood gas values and methemoglobin levels.

Patient teaching

• Teach patient to take oral drug 30 minutes before or 1 to 2 hours after a meal.
• Inform patient that drug may cause headache. Advise him to treat headache as usual and not to alter drug schedule. If headache persists, tell him to contact prescriber.
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure decrease.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

dy·na·min

(dī'nă-min),
A guanosine 5'-triphosphatase (i.e., GTPase) that, by surrounding the neck of a forming pinocytotic vesicle, pinches it off and frees it from the cell membrane, thus releasing it into the cytoplasm.
[G. dynamis, power, + -in]
References in periodicals archive ?
The study shows that cell or artificial membranes rich in polyunsaturated lipids are much more sensitive to the action of two proteins, dynamin and endophilin, which facilitate membrane deformation and fission.
Subsequent research by other scientists implicated dynamin in the process by which external entities get inside of cells.
The researchers identified two proteins, each linked to different aspects of sleep: phosphorylated dynamin 1 levels were related to how long it took to fall asleep, while phosphorylated N-myc gene 2 protein levels tracked the amount of sleep deprivation and corresponded to the well-known brain wave measure of sleep need.
The researchers identified two proteins that affected these responses, each linked to different aspects of sleep: phosphorylated dynamin 1 levels were linked to how long it took to fall asleep, while phosphorylated N-myc downstream regulated gene 2 protein levels tracked the amount of sleep deprivation and corresponded to the well-known brain-wave measure of sleep need, they report.
Nicotine modulates expression of miR-140*, which targets the 3'-untranslated region of dynamin 1 gene (Dnm1).
Based on studies in the 1980s, researchers had believed that a protein called dynamin, which comes in three forms (1, 2 and 3), was critical to this "membrane fission" step in the formation of vesicles.
The group's estimate is that 3 to 5 percent of all Labrador retrievers are affected and carry two copies of the mutant dynamin 1 gene.
The team found a mutant form of the dynamin 1 gene as highly associated with EIC.
Also, OTR desensitization has been able to be inhibited by dynamin and clathrin mutants in human embryonic kidney (HEK) 293 cells (41), as well as by concanavalin A (34), a lectin-type protein that reacts with specific sugar residues.
The proteins are, G protein-coupled receptor kinase 2, arrestins 2 and 3, and dynamin.
Dynamin as a new drug target for the treatment of glioblastoma

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