ISSN:
1432-1440
Keywords:
Isosorbide-5-mononitrate
;
Ischemic heart failure
;
Pharmacokinetics
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary This study compared the pharmacokinetics of orally administered isosorbide-5-mononitrate (20 mg) in patients with and without signs of ischemic heart failure after acute myocardial infarction. The central venous pressure was used as a parameter of global myocardial function and to separate 17 patients into two groups with normal (group I: CVP〈6 cmH2O; Killip class I;n=9) and elevated (group II: CVP〉-6 cmH2O; Killip class II–III;n=8) pressure. As compared to subjects with normal CVP patients with hemodynamic impairment showed a markedly lower peak concentration of isosorbide-5-mononitrate levels (475±32 vs 663±38 ngml−1;p〈0.01; mean±SEM) which occurred delayed (32±6 vs 55±9 s;p〈0.05). Reduced cardiac function also resulted in a prolonged elimination of isosorbide-5-mononitrate as was suggested by the diminished elimination rate constant (0.14±0.01 vs 0.18±0.01 h−1;p〈0.05). Thus, in patients with ischemic heart failure cardiac performance influences both the absorption and apparent elimination phase of oral isosorbide-5-mononitrate.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01646943
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