[Influence of the intravenous nitroglycerin dose on the appearance of drug tolerance].
Med Clin (Barc) 1995;
104:407-10. [PMID:
7715258]
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Abstract
BACKGROUND
There are few studies on the influence of different doses of intravenous nitroglycerin (NTG) on the appearance of drug tolerance.
METHODS
A controlled clinical trial was performed in 40 patients admitted to an ICU with the diagnosis of acute myocardial infarction (AMI). The patients were divided into two groups: group A with a continuous perfusion of NTG at 2 mg/h, and group B with 4 mg/h. At 30 minutes of the infusion, NTG was exchanged for a placebo in half of the patients of each group (subgroups A1 and B1) with the remaining patients continuing with NTG for 24 h (A2 and B2). The hemodynamic variables studied were central venous pressure (CVP), pulmonary capillary pressure (PCP), mean pulmonary artery pressure (PAP) and mean blood pressure (BP).
RESULTS
The patients in group A showed a decrease in the hemodynamic effects in all the variables studied. At 24 h of infusion no differences were observed with respect to the previous NTG values for CVP and PCP, with significant differences being maintained for PAP and BP. In group B the hemodynamic effect was maintained for all the variables during the 24 hours studied.
CONCLUSIONS
In patients with acute myocardial infarction, the dosis of nitroglycerin administered was found to have a determined influence in the appearance of drug tolerance with this fact being more evident on evaluation of the effect of nitroglycerin on the venous system.
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