- 1.1. The four stereo-isomers of pentitol pentanitrate (d-arabitol, l-arabitol, xylitol and adonitol pentanitrate) are highly effective in the prophylactic treatment of angina pectoris. They are especially effective when administered sublingually, but even when enclosed in gelatin capsules and swallowed, their use is followed by an increase in exercise tolerance in many patients. Clinically there is no clear-cut superiority of any one of these preparations over the other three; hence, the stereo-isomeric configuration of these compounds is not important in their utilization in angina pectoris.
- 2.2. d-isosorbide dinitrate (Isordil), when administered sublingually, is also highly effective in the prophylactic treatment of angina pectoris. The rapidly soluble sublingual form of Isordil is much more effective than is the more slowly soluble preparation intended to be swallowed. Following the use of the sublingual form of isosorbide dinitrate, an increase in exercise tolerance becomes evident within a few minutes and persists for as long as one to four hours in some patients. When taken after the induction of pain, the sublingual form of isosorbide dinitrate decreased the duration of discomfort of the patient whose attacks otherwise were usually longer than one minute in duration. The use of the “sustained-action” tablets was not followed by a detectable increase in exercise tolerance, although many patients experienced headache.
- 3.3. The activity of the nitrates in angina pectoris is not due to the number of —ONO2 groups in the nitrate molecule.
- 4.4. The lag in onset and the prolonged duration of effect of the nitrates imply that their action is not immediately dependent on the concentration of the pure drug in the blood stream.
- 5.5. Chlorothiazide and Recordil were of slight value in some patients with angina pectoris. The use of Amplivix and Persantin was not followed by any appreciable increase in exercise tolerance.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
- On the toxical and medicinal properties of nitrate of glycyl.Med. Times & Gazette. 1858; 16: 291
- Nitro-glycerine as a remedy for angina pectoris.Lancet. 1879; 1: 80
- The Bradshaw lecture on some new vaso-dilators.Brit. M. J. 1895; 2: 1213
- Current concepts in therapy. The treatment of angina pectoris.New England J. Med. 1959; 261: 1017
- Current concepts in therapy. The treatment of angina pectoris.New England J. Med. 1959; 261: 1126
- Current concepts in therapy. The treatment of angina pectoris.New England J. Med. 1959; 261: 1236
- Derives nitres de l'arabite et de la rhammite; constitution de certains ethers nitriques.Compt. rend. Acad. sc. URSS. 1901; 133: 641
- The pentitol pentanitrates.Canad. J. Chem. 1960; 38: 318
- Sur la constitution de la xylite et du xylose.Bull. Soc. Chim. 1891; 5: 740
- Alkyl nitrites. III. A pharmacologic study of a new series of organic nitrites.J. Pharmacol. & Exper. Therap. 1939; 67: 187
- Nitroglycerin and other nitrites in the treatment of angina pectoris.Circulation. 1958; 17: 22
- Pitfalls and precautions in coronary heart disease research.Angiology. 1962; 13: 457
- The electrocardiogram during attacks of angina pectoris, its characteristics and diagnostic significance.Am. Heart J. 1940; 19: 683
- Choice of a coronary vasodilator drug in clinical practice.J.A.M.A. 1953; 153: 207
- A standard exercise tolerance test for patients with angina pectoris on exertion.Am. J. M. Sc. 1934; 188: 646
- Objective evidence of the efficacy of medicinal therapy in angina pectoris.Am. Heart J. 1941; 22: 494
- The treatment of angina pectoris: A summary of ten years' objective study.New England J. Med. 1943; 229: 670
- Alkyl nitrites. VI. A contribution to the mechanism of the action of organic nitrates.J. Pharmacol. & Exper. Therap. 1940; 70: 323
- Sublingual erythrol tetranitrate in the treatment of angina pectoris. Effect of varying the dose and the rate of administration.Am. J. M. Sc. 1960; 240: 66
- The duration of attacks of angina pectoris on exertion and the effect of nitroglycerin and amyl nitrite.New England J. Med. 1937; 217: 470
☆This study was aided by Brewer and Company, Ives Cameron Company and Tailby Nason Company.