Culling W, Singh H, Bashir A, Griffiths B E, Dalal J J, Sheridan D J
Br J Clin Pharmacol. 1984 Feb;17(2):125-31. doi: 10.1111/j.1365-2125.1984.tb02326.x.
We measured plasma nitrate levels and haemodynamics following sublingual glyceryl trinitrate (GTN) (0.5 mg), or isosorbide dinitrate (ISDN) administered intravenously (0.5 mg) or by inhalation (1.25 mg) in 23 patients undergoing cardiac catheterisation for investigation of chest pain. Peak levels were detected at 90 s and 5 min following intravenous and inhaled ISDN respectively and at 3 min following sublingual GTN. Intravenous and inhaled ISDN produced similar plasma levels at 30 s and both were significantly greater than following sublingual GTN. Plasma levels were maintained for longer following inhaled ISDN than intravenous ISDN or sublingual GTN. Haemodynamic responses were qualitatively similar following each treatment; reduction in pulmonary vascular resistance and pressure and left ventricular end diastolic pressure occurred in each group. Heart rate, cardiac output and LV dP/dt.P-1 remained unchanged. Maximal haemodynamic responses were greater following ISDN than GTN, with little difference between the two preparations of ISDN. Haemodynamic responses were more sustained following inhaled ISDN than following sublingual GTN or intravenous ISDN, the latter two being similar in this respect. These findings suggest that inhaled ISDN may provide more rapid and sustained relief from angina than sublingual GTN.
我们对23例因胸痛接受心导管检查的患者，测量了舌下含服硝酸甘油（GTN）（0.5毫克）、静脉注射硝酸异山梨酯（ISDN）（0.5毫克）或吸入硝酸异山梨酯（1.25毫克）后的血浆硝酸盐水平和血流动力学变化。静脉注射和吸入ISDN后分别在90秒和5分钟时检测到峰值水平，舌下含服GTN后在3分钟时检测到峰值水平。静脉注射和吸入ISDN在30秒时产生的血浆水平相似，且均显著高于舌下含服GTN后的水平。吸入ISDN后血浆水平维持的时间比静脉注射ISDN或舌下含服GTN更长。每种治疗后的血流动力学反应在性质上相似；每组均出现肺血管阻力、压力以及左心室舒张末期压力降低。心率、心输出量和左心室dp/dt.P-1保持不变。ISDN后的最大血流动力学反应大于GTN，两种ISDN制剂之间差异不大。吸入ISDN后的血流动力学反应比舌下含服GTN或静脉注射ISDN更持久，后两者在这方面相似。这些发现表明，吸入ISDN可能比舌下含服GTN能更迅速、持久地缓解心绞痛。
