Naslov
Paradoxical blood pressure responses to nitroglycerin infusion in patients with acute coronary syndromes

Autori
Miličević, Goran ; Vrhovac, Božidar ; Goldner, Vladimir

Izvornik
Neurologia Croatica. Supplement (1331-5196) 50 (2001), Suppl 3; 155-159

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
nitroglycerin infusion; tolerance; acute coronary syndromes; blood pressure

Sažetak
In patients with acute coronary syndromes, efficacy of nitroglycerin (NG) infusion has to be monitored because of development of tolerance. Withdrawal of NG infusion increases blood pressure, while the acceleration of its rate decreases blood pressure. Blood pressure reactions to the changes in a NG dose can be opposite to the expected one. Incidence of such paradoxical reactions and influence of several factors on their appearance were analysed. Hypotensive efficacy of NG infusion was analysed in 60 patients with acute myocardial infarction or unstable angina. Initial efficacy was confirmed by a 10% blood pressure decrease (measured by cuff). Sevety-two hour NG infusion was interrupted, for 30 minutes, every 12 hours. If blood pressure increased for 10% after interruption of infusion, the infusion was continued at the previous rate. If blood pressure did not increase, the dose was increased until pressure decreased by 10% and the infusion was continued at the new dose. If a 5-fold dose increase did not decrease blood pressure, the infusion was stopped. NG infusion was interrupted 244 times and accelerated 158 times. After interruption of the infusion, blood pressure increased in 35% of measurements, it did not change in 62% and it paradoxically decreased in 3% of measurements. After the acceleration of NG infusion, blood pressure decreased in 75%, it did not change in 18% and it paradoxically increased in 7% of the measurements. Paradoxical pressure reactions were not related to sex, age, site or form of coronary artery disease, hyperlipidaemia, hyperglycaemia, previous use of oral nitrates or type of infusion vehicle, but they were related to the high NG doses administered

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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