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Las enfermedades del corazón son un tema tratado frecuentemente en las investigaciones médicas, debido a que repercuten ampliamente en el funcionamiento del cuerpo humano. Por lo anterior, se destaca el estudio del tratamiento de las afecciones de este órgano, lo que resulta en una importante tarea para mantener y potenciar los conocimientos sobre los adelantos terapéuticos de las enfermedades relacionadas con el mismo. Se realiza este trabajo con el objetivo de describir los avances en la terapia de la insuficiencia cardiaca. Para ello se realizó una revisión de publicaciones científicas de los últimos dos años. A pesar de que existen diferencias respecto a la terapia propuesta para la insuficiencia cardiaca, las asociaciones americanas y europea de cardiología establecen firmemente la terapia cuádruple (con los inhibidores del receptor de la angiotensina neprilysin, los ß-bloqueadores, los antagonistas de receptor de los mineralocorticoides y los inhibidores del cotransportador-2 de glucosa/sodio) -dirigida a la insuficiencia cardiaca con fracción de eyección reducida-, la recomendación del dinitrato de isosorbide/hidralazina para los pacientes de raza negra, y la utilización de la cardioversión implantable en la prevención de muerte súbita. Se concluye que la armonización de estas guías, en ambos continentes, proporciona un tratamiento único para la insuficiencia cardiaca, aunque necesita un estudio adicional en los pacientes con fracción de eyección del ventrículo izquierdo normal.
Heart diseases are a topic frequently treated in medical researches, due to their wide repercussion on the functioning of the human body; therefore, the study of the treatment of these organ affections is highlighted, being an important task to maintain and enhance knowledge about therapeutic advances in diseases related to it. This work is carried out with the aim of describing the advances in heart failure therapy. A review of the scientific publications of the last two years was performed. Although there are differences regarding the proposed therapy for heart failure, the American and European Associations of cardiology firmly establish the quadruple therapy (with angiotensin receptor inhibitors neprilysin, ß-blockers; mineralocorticoids antagonist receptors and glucose/sodium cotransporters-2 inhibitors-targeted at heart failure with reduced ejection fraction-, the recommendation of isosorbide dinitrate/hydralazine for black patients, and the use of implantable cardioversion in the prevention of the sudden death. It is concluded that the harmonization of these guidelines, in both continents, provides a unique treatment for heart failure, although it needs additional study in patients with normal left ventricular ejection fraction.
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Abstract Syncope in pediatrics represents an important cause of visits to the emergency units. For this reason, excluding a cardiac or malignant origin is essential at the time of the initial approach to determine what is the next step in management, or if they need to be referred to a pediatric cardiologist and/or electrophysiologist. Vasovagal syncope is the most frequent cause of syncope in pediatrics, in which a detailed clinical history is enough to make the diagnosis. If no diagnosis is concluded by the history, or if it is necessary to define the hemodynamic response of the patients, the head-up-tilt-test is indicated; this will trigger syncope due to an orthostatic stress caused by the angulated table (passive phase). If a negative response remains, it can be followed by a pharmacologic challenge to trigger the hemodynamic response, which is still controversial in pediatrics. The pharmacologic challenge increases the sensitivity with a slight reduction in test specificity. Although there is not a specific drug for the challenge in pediatric patients yet, the most commonly drugs used are nitrates and isoproterenol, the latter related to a great number of adverse effects. Sublingual administration of nitrates in the challenge has been proven to be ideal, effective, and safe in this specific age group. The aim of this article is to make a literature search to demonstrate the effectiveness and safety of the pharmacologic challenge during the head-up-tilt-test in pediatrics, emphasizing a study conducted at the National Institute of Cardiology with isosorbide dinitrate.
Resumen El síncope en edades pediátricas representa una causa importante en las visitas a unidades de urgencias, por lo que excluir un origen cardíaco o maligno es fundamental al momento del abordaje inicial para determinar la conducta a seguir o la necesidad de derivar al cardiólogo pediatra o electrofisiólogo. El síncope vasovagal (SVV) es la causa más frecuente de síncope en pediatría, para cuyo diagnóstico basta una historia clínica detallada. Cuando ésta no es suficiente para determinar el diagnóstico de síncope reflejo o es necesario definir el tipo de respuesta que lo origina, está indicada una prueba de mesa inclinada que produce un estrés ortostático por la angulación y ello desencadena un síncope (fase pasiva). En pruebas no concluyentes está indicado un reto farmacológico para precipitar la respuesta hemodinámica, pero aún es un tema de controversia en edades pediátricas. El reto farmacológico incrementa la sensibilidad de la prueba, con una ligera reducción de la especificidad. Si bien no existe todavía un medicamento específico para la población pediátrica, los más empleados son los nitratos y el isoproterenol, este último relacionado con un mayor número de efectos adversos. La administración sublingual de los nitratos utilizados ha demostrado ser ideal, efectiva y segura en los pacientes pediátricos. El objetivo del artículo es realizar una revisión de las publicaciones médicas que demuestran la efectividad y seguridad del reto farmacológico durante la prueba de mesa inclinada en pacientes pediátricos, con énfasis en un estudio conducido en el Instituto Nacional de Cardiología con dinitrato de isosorbida (DNIS).
Subject(s)
Humans , Child , Syncope/diagnosis , Tilt-Table Test/methods , Syncope, Vasovagal/diagnosis , Vasodilator Agents/adverse effects , Vasodilator Agents/pharmacology , Tilt-Table Test/adverse effects , Isoproterenol/adverse effects , Isoproterenol/pharmacology , Nitrates/adverse effects , Nitrates/pharmacologyABSTRACT
Objective@#To investigate the effect of isosorbide mononitrate (ISMN) targeted nanoparticles on inflammatory factors of sinusitis by establishing a rabbit model of rhinosinusitis.@*Methods@#Thirty healthy rabbits, male and female, weighing 2.5-3.5 kg, were randomly divided into 6 groups with 5 rabbits in each group. Group A was the control group. The model of rabbit sinusitis was established in group B to F, and CT was used to confirm the model was successful. After placing tubes into the maxillary sinus in the group C to F, saline, 45 mg/ml ISMN, 45 mg/ml ISMN nanoparticles and 45 mg/ml ISMN targeted nanoparticles were used to wash the maxillary sinus, respectively. Blood samples were collected from the ear vein of rabbits on day 7, 14, 21, 28, 35 and 42 after modeling respectively. Changes in the expression levels of inflammatory factors in rabbits during the modeling process and after drug washing were detected by ELISA. After the drug intervention, the maxillary sinus mucosa was taken for real-time quantitative PCR to detect the changes in the mRNA level of inflammatory factors. SPSS 22.0 software was used to process the data.@*Results@#Rabbit model of sinusitis was successfully established. ELISA showed that after the action of ISMN targeted nanoparticles of 1 week (42th day after modeling), the levels of (interleukin, IL) 4, IL-8, IL-17A and interferon γ (IFN-γ) in the blood were lower compared with that of 35th day after modeling, the difference was statistically significant (5.57±1.20 vs 19.73±0.68, 66.41±11.87 vs 154.68±13.13, 17.96±1.87 vs 28.23±0.80, 53.56±5.66 vs 111.93±7.29, all P<0.05). Compared with the ISMN nanoparticles and ISMN, the ISMN targeted nanoparticles reduced the levels of IL-4, IL-8, IL-17A and IFN-γ more obviously, the differences were statistically significant (13.26±1.43 vs 8.81±1.33 vs 7.14±2.16, 89.47±17.80 vs 41.07±7.77 vs 15.84±3.72, 10.28±2.07 vs 3.06±1.62 vs 1.82±0.90, 62.16±6.18 vs 35.12±4.62 vs 27.89±10.18, all P<0.05). Real-Time PCR showed that after the flushing of ISMN targeted nanoparticles, the levels of IL-4, IL-8, IL-17A and IFN-γ mRNA were lowest compared with that of the model group, ISMN nanoparticles and ISMN group.@*Conclusion@#ISMN targeted nanoparticles can reduce the level of inflammatory factors in rabbit sinusitis model.
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Objective To explore the clinical effect of Ginkgo biloba capsule combined with isosorbide mononitrate in the treatment of angina pectoris of coronary heart disease .Methods From April 22,2017 to April 22, 2018,100 patients with coronary heart disease and angina pectoris admitted to Zhoushan Traditional Chinese Medicine Hospital were enrolled in the study.Fifty patients in the control group were treated with isosorbide mononitrate.Fifty patients in the observation group were treated with Ginkgo biloba capsules and isosorbide mononitrate .The left ventricular end －diastolic diameter ( LVEDD), left ventricular end －systolic diameter ( LVESD), left ventricular ejection fraction (LVEF),duration of angina pectoris ,frequency of angina attacks ,total effective rate,incidence of adverse reactions, angina relief time were observed.Results The LVEDD, LVESD, LVEF, total effective rate, incidence rate of adverse reaction,duration of angina pectoris ,angina pectoris frequency and angina pectoris remission time in the observation group were (48.41 ±2.23)mm,(30.89 ±1.12)mm,(56.55 ±5.87)%,96.00%,4.00%, (3.44 ±1.52)min／time,(1.36 ±0.54)times／week,(3.12 ±0.56) min,respectively,which were better than those in the control group [LVEDD (64.78 ±2.89) mm,LVESD (42.21 ±1.55) mm,LVEF (43.46 ±1.52)%,total effective rate (74.00%), incidence rate of adverse reactions ( 28.00%), duration of angina pectoris (5.68 ± 1.66)min／time,frequency of angina pectoris (2.68 ±1.47)times／week,angina relief time (4.87 ±1.41)min] (t＝19.546,41.857,15.264,χ2 ＝9.490,10.714,t＝7.037,5.960,8.156,all P＜0.05).Conclusion Ginkgo biloba capsule combined with isosorbide mononitrate is effective in the treatment of patients with coronary heart disease and angina pectoris.
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OBJECTIVE: To determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA). METHODS: We conducted a prospective randomized open- label study in 70 women at 6–12 weeks of pregnancy at the R G Kar Medical College and Hospital, Kolkata, India, over a period of two years from 2015 to 2017. Forty milligrams of ISMN and 400 µg misoprostol were vaginally applied for cervical priming. The primary outcome measure was the cervical response assessed by the passage of the appropriate and largest sized MVA cannula through the internal os without resistance, at the beginning of the procedure. RESULTS: The base line cervical dilatation was found to be significantly higher in the misoprostol group than in the ISMN group (7.65±1.38 vs. 6.9±1.26 mm; P=0.025, 95% confidence interval, −1.4046 to −0.953). However, when the women were sub-analyzed based on parity, there was no statistically significant difference in the same parameters among the multigravid women. The need for further cervical dilatation was significantly higher in the ISMN group when the primigravid women were compared, although the multigravid women responded favorably to ISMN. CONCLUSION: In the primigravid women, misoprostol appears to exert a higher efficacy as a cervical ripening agent in contrast to ISMN. However, ISMN can be used in multigravid women for the same purpose as in this group, misoprostol did not show any significant improvement in efficacy over ISMN.
Subject(s)
Female , Humans , Pregnancy , Abortion, Induced , Catheters , Cervical Ripening , India , Labor Stage, First , Misoprostol , Outcome Assessment, Health Care , Parity , Pregnancy Trimester, First , Prospective Studies , VacuumABSTRACT
Objective@#To explore the clinical effect of Ginkgo biloba capsule combined with isosorbide mononitrate in the treatment of angina pectoris of coronary heart disease.@*Methods@#From April 22, 2017 to April 22, 2018, 100 patients with coronary heart disease and angina pectoris admitted to Zhoushan Traditional Chinese Medicine Hospital were enrolled in the study.Fifty patients in the control group were treated with isosorbide mononitrate.Fifty patients in the observation group were treated with Ginkgo biloba capsules and isosorbide mononitrate.The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), duration of angina pectoris, frequency of angina attacks, total effective rate, incidence of adverse reactions, angina relief time were observed.@*Results@#The LVEDD, LVESD, LVEF, total effective rate, incidence rate of adverse reaction, duration of angina pectoris, angina pectoris frequency and angina pectoris remission time in the observation group were (48.41±2.23)mm, (30.89±1.12)mm, (56.55±5.87)%, 96.00%, 4.00%, (3.44±1.52)min/time, (1.36±0.54)times/week, (3.12±0.56)min, respectively, which were better than those in the control group [LVEDD (64.78±2.89)mm, LVESD (42.21±1.55)mm, LVEF (43.46±1.52)%, total effective rate (74.00%), incidence rate of adverse reactions (28.00%), duration of angina pectoris (5.68±1.66)min/time, frequency of angina pectoris (2.68±1.47)times/week, angina relief time (4.87±1.41)min] (t=19.546, 41.857, 15.264, χ2=9.490, 10.714, t=7.037, 5.960, 8.156, all P<0.05).@*Conclusion@#Ginkgo biloba capsule combined with isosorbide mononitrate is effective in the treatment of patients with coronary heart disease and angina pectoris.
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OBJECTIVE： To study the effects of Dengzhan shengmai capsules combined with isosorbide mononitrate on serum TIMP-1 and MMP-9 levels， blood lipid level and cardiac function in patients with unstable angina pectoris （UAP）. METHODS： Totally 198 UAP patients admitted to our hospital from Apr. 2016 to Apr. 2019 were selected， and divided into observation group （n＝102） and control group （n＝96） according to therapy plan. Control group received Isosorbide mononitrate tablets 40 mg， qd， orally； observation group additionally received Dengzhan shengmai capsules， 2 capsules per time， tid， orally， on the basis of control group. Both groups received treatment for consecutive 4 weeks. The clinical efficacy， serum levels of MMP-9 and TIMP-1， blood lipid indexes [low density lipoprotein cholesterol （LDL-C）， high density lipoprotein cholesterol （HDL-C）， triglyceride （TG）， total cholesterol （TC）]， cardiac function indexes [end-diastolic volume （EDV）， left ventricular ejection fraction （LVEF）， end-systolic volume （ESV）] and ADR were compared between 2 groups. RESULTS： The total response rate of observation group was significantly higher than control group （91.18％ vs. 70.83％， P＜0.05）. Before treatment， there was no statistical significance in the levels of ESV， MMP-9， TIMP-1， TC， LDL-C， TG， HDL-C， EDV and LVEF between 2 groups （P＞0.05）. After treatment， the levels of MMP-9， TC， LDL-C， TG， ESV and EDV in 2 groups were decreased significantly in both groups， and the observation group was significantly lower than the control group （P＜0.05）； meanwhile， the levels of TIMP-1， HDL-C and LVEF in 2 groups were increased significantly， and the observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of total ADR in 2 groups （P＞0.05）. CONCLUSIONS： Dengzhan shengmai capsules combined with isosorbide mononitrate show good clinical efficacy for UAP， which can effectively reduce serum MMP-9 level and increase serum TIMP-1 level， reduce blood lipid levels， as well as improve cardiac function for UAP patients， with good safety.
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Objective To observe the clinical effect of isosorbide mononitrate combined with metoprolol in the treatment of coronary heart failure.Methods From January 2015 to May 2017,100 patients with coronary heart failure treated in the Second People's Hospital of Yuyao were randomly divided into two groups according to the digital table,with 50 cases in each group.The conventional group was treated with conventional therapy.The observation group was treated with isosorbide mononitrate combined with metoprolol on the basis of conventional treatment for 30 days.The clinical efficacy,cardiac function index and plasma BNP level were compared between the two groups.Results The total effective rate of the observation group was 96.0％ (48/50),which was higher than 78.0％ (39/50) in the conventional group(x2 =7.161,P ＜ 0.01).After treatment,the cardiac drainage index(CI) [(3.14 ± 0.53) L · min-1 · (m2)-1],cardiac output blood volume (CO) [(5.62 ± 0.95) L/min],each stroke volume (SV) [(79.24 ± 2.56) mL],left ventricular ejection fraction (LVEF) [(61.62 ± 4.95) ％] in the observation group were better than those in the conventional group[(2.41 ±0.45) L · min-1 · (m2)-1,(4.79 ± 0.23) L/min,(72.30 ± 2.78)mL,(53.79 ±4.23)％,t =7.043,5.696,12.318,8.066,all P ＜0.05].The BNP level of the observation group was (172.17 ± 10.36) pg/mL,which was lower than (215.47 ± 12.48) pg/mL of the conventional group (t =17.908,P ＜ 0.05).Conclusion The treatment of coronary heart failure with isosorbide mononitrate and metoprolol can improve the clinical effect and improve cardiac function.
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Objective To assess the effect of isosorbide dinitrate on the improvement of cardiac function after cardiopulmonary resuscitation (CPR) by regulating myocardial cells apoptosis..Methods Total of 30 domestic pigs were divided into three groups randomly (random mumber) after anesthetization:the sham group (n=6),the control group (n=12),and the isosorbide dinitrate group (n=12).Cardiac arrest of ventricular fibrillation was induced by programed electrical stimulation in the control and isosorbide dinitrate groups.Isosorbide dinitrate was infused at the rate of 2 μg/(kg·min) in the isosorbide dinitrate group.Coronary perfusion pressure (CPP) and cardiac output (CO) were recorded at baseline,2,6,12 and 24 h after restoration of spontaneous circulation (ROSC).Myocardial enzyme and heart fatty acid binding protein (H-FABP) was tested at the same time points.At 24 h after ROSC,the animals were sacrificed to obtain the myocardium for pathological section and Western blot.The expression of Bcl-2,Bax and activated Caspase-3 were tested and apoptosis was tested by TUNEL and apoptosis index was calculated.Results Right atrial pressure (RAP) increased after ROSC and decreased in the isosorbide dinitrate group compared with the control group (P＜0.05).CPP at 12,24 h after ROSC and CO at 24 h after ROSC in the isosorbide dinitrate group increased significantly compared with the control group (both P＜0.05).HE staining revealed that the injury of myocardial cells was ameliorated in the isosorbide dinitrate group.Apoptosis index of the isosorbide dinitrate group significantly decreased than the control group [(37.8±15.5)％ vs (13.1±0.5)％,P＜0.05].The expression of Bax and activated Caspase-3 decreased while Bcl-2 and Bcl-2/Bax increased after ROSC in the isosorbide dinitrate group compared with the control group (all P＜0.05).Conclusions Isosorbide dinitrate could improve the isehemia/reperfusion injury and cardiac function after ROSC by inhibiting apoptosis regulated with Caspase-3 pathway.
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Objective To observe the clinical efficacy and safety of Danshen Chuanxiongqin injection combined with Isosorbide dinitrate on the treatment of myocardial ischemia.Methods 78 patients with myocardial ischemia from January 2015 to July 2016 were divided into the observation group and the control group, with 39 cases in each group.The control group received Isosorbide dinitrate therapy, the observation group received Danshen Chuanxiongqin injection joint Isosorbide dinitrate therapy.To analysis the clinical efficacy,electrocardiogram, TG,TC,the whole blood high and low-shear viscosities and adverse reactions between two groups.Results After treatment, total effective rate of the observation group was 89.74%, higher than the control group with 66.67%( P<0.05 ) .After treatment, ST segment depression occurred frequency and ST segment depression duration time of two groups were lower than before treatment(P<0.05),ST segment depression occurred frequency and ST segment depression duration time of observation group were lower than the control group (P<0.05).After treatment, TG and TC level of two groups were lower than before treatment(P<0.05),TG and TC level of the observation group were lower than the control group (P<0.05).After treatment,the whole blood high and low-shear viscosities of two groups were lower than before treatment(P<0.05),the whole blood high and low-shear viscosities of the observation group were lower than the control group ( P <0.05 ) .During treatment, there was no significant difference in adverse reaction rate between the two groups.Conclusion Danshen Chuanxiongqin injection combing with Isosorbide dinitrate has a better efficacy on the treatment of myocardial ischemia than only Isosorbide dinitrate ,and it is a safe treatment therapy.
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Objective To investigate the effect of isosorbide mononitrate on the levels of NO,iNOS,IL-1 and IL-6 in lung tissue of spontaneously hypertensive rats (SHR).Methods Fourteen-week-old Wistar and SHR male rats were randomly divided into the W0,W1,S0 and S1 group,with 10 rats ineach group.Rats in the W0 and S0 group were fed with the normal saline and the ordinary food,rats in the W1 and S1 group were fed with isosorbide mononitrate and the ordinary food.Twelve weeks later,levels of NO,iNOS,IL-1 and IL6 in rat lung tissue were detected.Results Compared with the W0 group,levels of NO,iNOS,IL-1 and IL6 were significantly increased in the W1 groups (P ＜ 0.05,respectively).Compared with the SO group,levels of NO,iNOS,IL-1 and IL6 were significantly increased in the S1 group (P ＜ 0.05,respectively).In the W1 and S1 group,levels of iNOS and NO were positively correlated with IL-1 and IL-6.Conclusion 1.Isosorbide mononitrate may lead to increases of NO,iNOS,IL-1 and IL6 in lung tissue of Wistar rats,which indicates the presence of chronic inflammation.2.Longterm feeding of isosorbide mononitrate may lead to increases of inflammatory factors in SHR rats,contributing to the inflammatory state in rats.
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Objective:To observe the clinical efficacy and safety of Sofre injection combined with isosorbide mononitrate in the treatment of refractory heart failure. Methods:Totally 66 cases of patients with refractory heart failure in our hospital were randomly di-vided into the observation group and the control group with 33 cases in each. Each patient received the conventional treatment. On the basis of routine treatment, the control group was treated with isosorbide mononitrate injection (25mg,qd,ivd). On the basis of control group, the observation group was treated with Sofre injection (10ml, qd, ivd). The treatment course was 14 days. Before and after the treatment, the improvement degree clinical symptoms, left ventricular ejection fraction ( LVEF) , left ventricular end diastolic diameter (LVEDD), cardiac index (CI), stroke volume (SV) and 6-min walking distance (6MWD) were observed, and the rate of heart fail-ure hospitalization, heart failure mortality and 6MWT changes were followed up for 6 months in the two groups. The adverse drug reac-tions ( ADR) in both groups during the treatment were recorded as well. Results:After the 2-week treatment, the effective rate and the total effective rate of the observation group were significantly higher than those of the control group (P<0. 05); LVEF, CI, SV and 6MWD of the two groups after the treatment were significantly higher than those before the treatment, and LVEDD significantly de-creased (P<0. 05), and the improvement of the observation group was more obvious than that of the control group (P<0. 05). After the 6-month follow-up, 6MWD was significantly longer in the observation group than that in the control group (P<0. 05), while there were no statistically significant differences in the hospitalization rate and the mortality rate between the groups (P>0. 05). There were no adverse reactions in both groups during the whole treatment. Conclusion:Sofre injection combined with isosorbide mononitrate can significantly improve cardiac function in the patients with refractory heart failure with improved clinical efficacy and good safety.
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Objective To determine the protective effect of isosorbidemononitrate (IM) on myocardial injury after restoration of spontaneous circulation (ROSC)in swine models of cardiac arrest induced by ventricular fibrillation.Methods The experiment was carried out in Animal Lab of Beijing Chao-Yang Hospital,Capital Medical University.Ventricular fibrillation was induced and untreated for 8 min in twenty WhuZhiShan piglets.CPR was performed until ROSC occurred.The animals were randomized (random number)into two groups:IMgroup (n =10)and control group (n =10).IM [2 μg/(kg· min)]or the equivalent volume in saline was administered respectively for 6 h after ROSC.Hemodynamics and post-resuscitation cardiac function were monitored until 24 h after ROSC. Echocardiography and transmission electron microscopy were useed at 72 h after ROSC.Results There was no significant difference in survival rate between the two groups.No significant differences in mean arterial pressures (mmHg)at ROSC 6 h (88.5 ±5.6 vs.87.8 ±6.0,P =0.790)and ROSC 24 h (89.3 ±3.8 vs.86.9 ± 5.0,P =0.245)between the two groups were found.Cardiac outputs (L/min)were significantly increased at ROSC 6 h (2.40 ±0.17 vs.1.60 ±0.14,P <0.01)and ROSC 24 h (2.49 ±0.17 vs.2.09 ±0.21,P<0.01);and ejection fraction at ROSC 72 h (0.67 ±0.08 vs.0.56 ±0.09,P =0.044)was improved too,and significant differences were found between the two groups.The ultra-structural myocardial injury was ameliorated in the MI group at 72 h after CPR observed by using electron microscopy.Conclusions IM can ameliorate post-resuscitation cardiac dysfunction in porcine models of cardiac arrest induced by ventricular fibrillation.
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@#The aim of the study was to investigate the effect of oleic acid(OA)and isosorbide mononitrate(ISMN)on the phase diagrams of glyceryl monooleate(GMO)liquid crystalline systems and release of ISMN from them. Liquid crystalline systems of GMO/H2O, GMO/H2O/ISMN and GMO/H2O/OA were prepared and their phase diagrams were plotted. Investigation of water absorption of GMO and ISMN release profiles shown that the release mechanism of ISMN was diffusion-controlled. Increased drug loading accelerated the release rate. However, the increased loading of OA decreased ISMN release. The result could offer practical basis for drug loading and the selection of additives in GMO liquid crystalline system.
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OBJECTIVES: Mèniére's disease is one of the most common causes of episodic vestibular syndrome that shows symptom complexes of recurrent vertigo, hearing loss, tinnitus and ear fullness. Isosorbide (Isobide) is a osmotic diuretics which has been used for Meniere's disease to reduce the endolymphatic pressure. The purpose of this study was to evaluate the efficacy of isosorbide in the treatment of Mèniére's disease by comparing the combined therapy of isosorbide and betahistine (Meniace) to betahistine only. METHODS: Among 220 patients enrolled with Mèniére's disease from 9 centers, 187 patients completed this clinical study. Patients were randomly subjected either to betahistine alone therapy at dose of 6 mg three times a day (n=97) or to combined therapy with isosorbide (dose of 30 mL three times a day) and betahistine (n=90) for 12 weeks. Two groups were compared at 4 and 12 weeks after treatment on frequency of vertigo, hearing level (pure tone audiometry, speech audiometry), electocochleography (ECoG), tinnitus (Tinnitus Handicap Inventory, THI) and quality of life (Korean functional level scale, Korean dizziness handicap inventory). RESULTS: During first 4 weeks after treatment, the frequency of vertigo was not reduced in either betahistine alone therapy group or combined therapy group. However, between 8 and 12 weeks, the frequency of vertigo was significantly reduced in either group, and in the combined group frequency of vertigo was more significantly reduced than in the betahistine alone therapy group (p=0.041). The hearing level, ECoG, tinnitus and quality of life was not significantly different between two groups. CONCLUSION: Isosorbide and betahistine combined therapy were more effective for vertigo control than betahistine alone therapy. Isosorbide is an effective diuretic in vertigo control in definite Mèniére's disease.
Subject(s)
Humans , Audiometry, Speech , Betahistine , Clinical Study , Diuretics, Osmotic , Dizziness , Ear , Hearing , Hearing Loss , Isosorbide , Meniere Disease , Quality of Life , Tinnitus , VertigoABSTRACT
Objective To observe the influence of insulin resistance(IR) and isosorbide mononitrate(ISMN) on myocardial cellular apoptosis in spontaneously hypertensive rats (SHR) .Methods Forty male 14‐week old Wistar(W) rats and SHR(S) each were respectively or jointly fed with normal diet (ND) ,high fat and high glucose(HFHG) diet ,normal saline(NS)and ISMN by ga‐vage .Then they were randomly divided into the normal and NS group (normal W and normal S ) ,HFHG and NS group(HFHG W and HFHG S) ,normal and ISMN group(ISMN W and ISMN S) ,HFHG and ISMN group(HI W and HI S) ,with 10 rats in each group .After 12‐week feeding ,carotid arterial blood was collected for detecting blood glucose concentration and insulin level and cal‐culating insulin resistance index (HOMA‐IR);4 myocardial tissue samples were taken for respectively observing the morphology under microscope ,and detecting the NO level ,myocardial Bcl‐2 ,Bax gene and their protein expression levels in myocardial tissue . Results Myocardial NO level ,Bax gene mRNA and related protein levels in the HFHG and ISMN intervention groups were higher than those in the normal group ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;myocardial tissue NO level ,Bax gene mRNA and related protein expression in the S groups were increased compared with the corresponding W groups ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;in the HFHG W group ,the myocardial tis‐sue NO level had significantly positive correlation with HOMA‐IR ,and in the ISMN W group ,HOMA‐IR was positively correlated with the NO level in the myocardial tissue .Conclusion Myocardial cellular apoptosis of SHR is increased compared with Wistar rats ;both IR and ISMN can aggravate the apoptosis of SHR myocardial cells ,moreover IR has a mutual induction and reciprocal causation with ISMN .
ABSTRACT
The purpose of this study was to develop a reservoir-type transdermal delivery system for isosorbide dinitrate (ISDN). The developed patch consisted of five layers from bottom to top, namely, a temporary liner, an adhesive layer, a rate-controlling membrane, a reservoir and a backing. The effects of chemical penetration enhancers, reservoir materials and rate-controlling membranes on the release behaviour of ISDN from the transdermal patch were studied, and the
O objetivo do presente estudo foi desenvolver um sistema de liberação transdérmico do tipo reservatório para o dinitrato de isossorbida (ISDN, abrevitura em Inglês). A formulação transdérmica desenvolvida constou de cinco camadas de baixo para cima, ou seja, um revestimento temporário, uma camada adesiva, uma membrana controladora da taxa de liberação, um reservatório e um reforço. Estudaram-se os efeitos dos potenciadores de penetração química, materiais do reservatório e membranas de controle da taxa de liberação no comportamento da formulação transdérmica de dinitrato de isossorbida. A liberação
Subject(s)
Humans , Isosorbide Dinitrate/administration & dosage , Isosorbide Dinitrate/analysis , Isosorbide Dinitrate/pharmacokinetics , Isosorbide Dinitrate/pharmacology , Administration, Cutaneous , Angina Pectoris/drug therapy , Chemistry, Pharmaceutical , PermeabilityABSTRACT
Background: Chronic anal fissure is a common disease that is accompanied with pain and bleeding during defecation. Various surgical and non-surgical methods have been offered for the treatment of this condition. Objective: The aim of this randomised clinical study was to compare the effectiveness and safety of nifedipine and isosorbide dinitrate (ISDN) in the treatment of chronic anal fissure. Methods: This double-blind clinical trial study was performed on patients aged 20 to 60 years old in 2012 to 2013. The samples with a primary diagnosis of chronic anal fissure were enrolled from the patients admitted to public treatment at the educational Imam Ali Clinic, Shahrekord, Iran by researchers and general surgery specialists. The patients were randomised into two groups: nifedipine 0.3% (n = 35) or ISDN 0.2% (n = 35) applied three times a day for three weeks. The patients were examined on the 7th, 14th, and 21st days of treatment, and the symptoms including bleeding, pain, and healing status, as well as the side effects of the drugs, were assessed. Pain was evaluated using a visual analogue scale (VAS). Results: After 21 days of follow-up, complete healing was achieved in 77.1% (n = 27) of patients in the nifedipine group and 51.4% (n = 18) in the ISDN group (P = 0.05). The mean VAS of the pain on day 21 was 0.91 (SD 0.01) in the ISDN group and 0.45±0.78 in the nifedipine group, with a statistically significant difference (P = 0.038). The bleeding was similar in the two groups (P = 0.498). Conclusion: In view of the findings on healing status and pain in the patients, nifedipine may be significantly more effective in the treatment of chronic anal fissure than ISDN.
ABSTRACT
Objective:To prepare compound isosorbide mononitrate sustained-release capsules and study the drug release. Meth-ods:Isosorbide mononitrate pellets were prepared by the fluidized bed coating technology. The influencing factors in the preparation process were examined and the major factors were optimized by single factor experiments. The drug release was determined by HPLC. The best formula was screened by optimizing aspirin coating solution. Results:The compound isosorbide mononitrate sustained-release capsules were prepared by the best formula. Both the two drugs could achieve promising release, and in vitro release behavior of isosor-bide mononitrate was fitted Higuchi equation,which was similar to that of the imported preparations. The release of aspirin in acidic and alkaline media was in coincidence with the release requirements. Conclusion:The formula is reasonable and the preparation process is stable with promising sustained release property.
ABSTRACT
OBJECTIVE: To study the effect of isosorbide-5-mononitrate (5-ISMN) on ivabradine hydrochloride pharmacokinetics in Beagles.