Steady state pharmacokinetic haemodynamic studies of intravenous nitroglycerin in congestive cardiac failure. 1983

P W Armstrong, and D G Watts, and J A Moffat

We conducted pharmacokinetic haemodynamic studies in 10 patients with congestive cardiac failure to determine both the time to steady state concentration after commencement of a standard infusion rate of 21 micrograms/min i.v. GTN and the haemodynamic response once steady state plasma concentration ws achieved. Nitroglycerin was detected in plasma 2 min after commencement of the infusion, the concentration rose to a peak of approximately 4 ng/ml at 30 min and was maintained throughout the balance of the infusion period. During GTN infusion heart rate, systolic blood pressure and cardiac index were unchanged; there was significant declines (P less than 0.01) in pulmonary systolic pressure (SPA) (52 to 42 mm Hg), pulmonary capillary wedge pressure (PCWP) (26 to 20 mm Hg), and right atrial pressure (RAP) (12 to 8 mm Hg). These pressure changes were first evident within 5 min, approached maximum by 10 min and were maintained throughout the remainder of the infusion period. A one compartment model fitted to haemodynamic and GTN data revealed time constants (+/- approximate standard error) for SPA, PCWP, RAP and GTN of 8.2 (3.4), 9.7 (3.0), 8.1 (3.8) and 8.1 (1.9 respectively. Clearance for GTN was 6.2 +/- 2.7 (s.d.) 1 min. These data demonstrate steady state concentration of GTN is approached asymptotically with a time constant of 8.1 min during i.v. infusion of 21 micrograms/min. The time constants for haemodynamic measurement most sensitive to GTN's effect, i.e. SPA, PCW and RAP were remarkably similar to the time constant found for GTN concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007263 Infusions, Parenteral The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping. Intra-Abdominal Infusions,Intraperitoneal Infusions,Parenteral Infusions,Peritoneal Infusions,Infusion, Intra-Abdominal,Infusion, Intraperitoneal,Infusion, Parenteral,Infusion, Peritoneal,Infusions, Intra-Abdominal,Infusions, Intraperitoneal,Infusions, Peritoneal,Intra Abdominal Infusions,Intra-Abdominal Infusion,Intraperitoneal Infusion,Parenteral Infusion,Peritoneal Infusion
D007700 Kinetics The rate dynamics in chemical or physical systems.
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002302 Cardiac Output The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat). Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D005260 Female Females
D005996 Nitroglycerin A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives. Glyceryl Trinitrate,Anginine,Dynamite,Gilustenon,Nitrangin,Nitro-Bid,Nitro-Dur,Nitrocard,Nitroderm,Nitroderm TTS,Nitroglyn,Nitrol,Nitrolan,Nitrong,Nitrospan,Nitrostat,Perlinganit,Susadrin,Sustac,Sustak,Sustonit,Transderm Nitro,Tridil,Trinitrin,Trinitrolong,Nitro Bid,Nitro Dur,NitroBid,NitroDur,Trinitrate, Glyceryl
D006333 Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION. Cardiac Failure,Heart Decompensation,Congestive Heart Failure,Heart Failure, Congestive,Heart Failure, Left-Sided,Heart Failure, Right-Sided,Left-Sided Heart Failure,Myocardial Failure,Right-Sided Heart Failure,Decompensation, Heart,Heart Failure, Left Sided,Heart Failure, Right Sided,Left Sided Heart Failure,Right Sided Heart Failure
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse

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