Reisin L H, Landau E, Darawshi A
Cardiology Department, Barzilai Hospital, Ashkelon, Israel.
Am J Cardiol. 1988 Mar 25;61(9):2E-3E. doi: 10.1016/0002-9149(88)90079-3.
To evaluate the possibility of improving clinical practice in the treatment of angina pectoris, the duration of relief of pain with isosorbide dinitrate (ISDN) oral spray and sublingual tablets were compared in elderly patients with chronic stable angina pectoris. Nine patients (mean age 67 years) were studied in a randomized crossover trial. The patients underwent bicycle ergometry, which resulted in typical chest pain associated with electrocardiographic ST-segment depression in all 9. The patients received ISDN oral spray or sublingual tablets immediately on termination of exercise. At least 6 hours later another ergometry test was performed and the patients were crossed over to the other drug. ISDN spray relieved pain in all patients at a mean duration of 61.6 +/- 24.4 seconds after administration, whereas the duration of relief of pain by ISDN sublingual tablets was 112.4 +/- 70 seconds. The difference was highly significant (p less than 0.0005). It is concluded that clinical practice of treatment of angina pectoris in the elderly can be improved by using ISDN oral spray rather than sublingual tablets. The spray is effective at twice the rapidity of the sublingual tablet.
为评估改善心绞痛治疗临床实践的可能性，在老年慢性稳定型心绞痛患者中比较了硝酸异山梨酯（ISDN）口腔喷雾剂和舌下片缓解疼痛的持续时间。在一项随机交叉试验中对9例患者（平均年龄67岁）进行了研究。患者进行了自行车测力计运动试验，所有9例患者均出现与心电图ST段压低相关的典型胸痛。患者在运动结束时立即接受ISDN口腔喷雾剂或舌下片。至少6小时后进行另一次测力计运动试验，患者换用另一种药物。ISDN喷雾剂给药后在所有患者中缓解疼痛的平均持续时间为61.6±24.4秒，而ISDN舌下片缓解疼痛的持续时间为112.4±70秒。差异具有高度显著性（p<0.0005）。得出结论，老年人心绞痛治疗的临床实践可通过使用ISDN口腔喷雾剂而非舌下片得到改善。喷雾剂的起效速度是舌下片的两倍。
