RESUMO
To assess the exact cause and extent of transdermal glyceryl trinitrate (GTN)-induced allergic reactions, a study of continuous and intermittent use of GTN patches was conducted in 320 patients with New York Heart Association (NYHA) class II and III angina pectoris. Three commercially available GTN patch systems were used. Twenty-one patients (6.5%) developed cutaneous reactions. In 17 patients (5.3%), the reactions were confined to the area of application and were characterised as irritant reactions. Four patients (1.2%) developed both localised and remote from the area of application lesions and one patient developed a generalised anaphylactic reaction. The rate of discontinuation of therapy was 3.4%. The irritant skin reactions were mainly due to contaminants and additives. Changing to a different transdermal system reduced the incidence of local reactions--a particularly desirable effect in patients who respond well to GTN therapy.
Assuntos
Toxidermias/etiologia , Nitroglicerina/efeitos adversos , Adesivos/efeitos adversos , Administração Cutânea , Idoso , Angina Pectoris/tratamento farmacológico , Dermatite de Contato/etiologia , Esquema de Medicação , Feminino , Glicerol/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/tratamento farmacológico , Nitroglicerina/administração & dosagem , Testes do Emplastro , Silicones/efeitos adversosRESUMO
Six women suffering from Wolff-Parkinson-White syndrome and who were previously asymptomatic or nearly asymptomatic, were followed prospectively during and after their subsequent pregnancies. Three women experienced several attacks of supraventricular tachycardia (SVT) for the first time and the rest experienced an increase in their attacks. It seems that there is an increased tendency for SVT in pregnancy. Increased adrenergic sensitivity by estrogens, increased plasma volume, stress, and anxiety during pregnancy may be some of the causative factors.
Assuntos
Complicações Cardiovasculares na Gravidez/fisiopatologia , Taquicardia Supraventricular/diagnóstico , Síndrome de Wolff-Parkinson-White/fisiopatologia , Adulto , Ecocardiografia , Eletrocardiografia/métodos , Eletrocardiografia Ambulatorial , Feminino , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Estudos Prospectivos , Processamento de Sinais Assistido por Computador , Taquicardia Supraventricular/etiologia , Síndrome de Wolff-Parkinson-White/diagnósticoRESUMO
To determine the effects of intravenous nitroglycerin on the velocities and excursions of the acutely ischemic myocardium, 20 open-chest dogs were studied by use of ultrasound. In 10 dogs with acute septal ischemia, the posterior wall excursion during contraction (B-C excursion), the mean systolic posterior wall velocity, and the posterior wall excursion remained unaltered. Nitroglycerin, however, increased all these parameters (P less than 0.01). In 10 dogs with acute posterior wall ischemia the B-C excursion (aneurysmal bulging) increased (P less than 0.01), but the mean systolic posterior wall velocity and posterior wall excursion decreased (P less than 0.01). Nitroglycerin increased even more the aneurysmal bulging (P less than 0.01) and the other parameters (P less than 0.01). Increased regional blood flow, reduced afterload, and mechanical pulling of the ischemic myocardium seem to be a possible mechanism. The measurements were obtained using the recently described method of the specific points.
