isosorbide dinitrate

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isosorbide dinitrate

Angitak (UK), Apo-ISDN (CA), Cedocard (UK), Cedocard-SR (CA), Dilatrate-SR, Isochron, Isoket (UK), Isordil Titradose, Novo-Sorbide (CA), PMS-Isosorbide (CA), Soni-Slo SR, Sorbid

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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

i·so·sor·bide di·ni·trate

(ī'sō-sōr'bīd dī-nī'trāt),
A coronary vasodilator that acts via the formation of nitric oxide.
Farlex Partner Medical Dictionary © Farlex 2012

isosorbide dinitrate

(ī′sō-sôr′bīd′ dī-nī′trāt′)
n.
A vasodilator drug, C6H8N2O8, used to treat and prevent angina pectoris.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

isosorbide dinitrate

Cardiology A venodilating nitrate used with hydralazine in CHF; ID ↓ cardiac filling pressure, ↑ exercise tolerance. See Nitrates.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

isosorbide dinitrate

A drug used to prevent or relieve ANGINA PECTORIS and in to treat HEART FAILURE. The drug is on the WHO official list. Brand names are Angitak, Cedocard Retard, Isoket and Isotek Retard.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Based on the reported Zircon SHRIMP dating results of granites (Table 3), combined with the Rb-Sr isochron ages of the Dongfeng gold deposit, this paper discussed the relationship between the Mesozoic magmatism and the Dongfeng gold mineralization.
they fail to explain why there are so many cases where there is good concordance of isochrons ..." (p.
Our data from various layers of Bilong Co oil shale do not define isochrons.
Isochron will combine its own software, mobile computing applications and embedded systems with Bluetooth software and hardware from Socket.
Sano [38] reported Sm-Nd whole rock and mineral isochron ages of 409 [+ or -] 44 Ma and 412 [+ or -] 62 Ma, respectively, for the metagabbro of MORB origin in the Ayabe area (Figure 1).
The interpretation that most consistently integrates the Sm/Nd isochron age, major element growth zoning in the garnets, microstructural evidence for garnet growth during deformation, and peak temperature estimate is that the sampled formation reached amphibolite facies conditions and was deformed at c.
62); however, the CEP is determined in terms of the accuracy with which the isochrones and isofreqs are calculated.
where m is the slope of the secondary isochron, [lambda]5 and [lambda]8 are the decay constants of 235U and 238U, respectively, [t.sub.1] and [t.sub.2] are the production ages of the radiogenic leads, and a calculated slope of 0.0773628 from the data of Ayuso et al.
The sphalerites from the sediment-hosted Zn-Pb ores at the Mayuan district have been dated with a Rb-Sr isochron age of 486 [+ or -] 12 Ma (Ordovician, Li et al.
Similarly, Rb-Sr whole-rock isochron ages of 412 [+ or -] 12 Ma and 411 [+ or -] 13 Ma (Poole 1980), and K-Ar (muscovite) and K-Ar (biotite) ages of 408 [+ or -] 7 Ma and 402 [+ or -] 4 Ma, respectively (Whalen and Theriault 1990) compare well with the 409.7 [+ or -] 0.5 Ma crystallization age of the Lost Lake Granite.