Penta-erythritol Tetranitrate in Treatment of Angina

Weitzman, David

doi:10.1136/bmj.2.4851.1409

Cited by 14 publications

(2 citation statements)

References 5 publications

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“…Nitrate compounds have been used in clinical practice for decades; their application for angina pectoris started in the 19th century. The first medicines included amyl nitrite (Brunton, 1867), glycerol trinitrate (nitroglycerin) (Ebright, 1914), erythritol‐tetranitrate and penta‐erythrol‐tetranitrate (Weitzman, 1953). Other nitrates have also been introduced into medicine such as sodium nitroprusside for hypertension emergency (Page et al.…”

Section: Different Nitrate Preparations and The Frequency Of Headachementioning

confidence: 99%

Headache‐type adverse effects of NO donors: vasodilation and beyond

Bagdy

Riba

Kecskeméti

et al. 2010

British J Pharmacology

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Although nitrate therapy, used in the treatment of cardiovascular disorders, is frequently associated with side-effects, mainly headaches, the summaries of product characteristics of nitrate-containing medicines do not report detailed description of headaches and even do not highlight the possibility of nitrate-induced migraine. Two different types of nitrate-induced headaches have been described: (i) immediate headaches that develop within the first hour of the application, are mild or medium severity without characteristic symptoms for migraine, and ease spontaneously; and (ii) delayed, moderate or severe migraine-type headaches (occurring mainly in subjects with personal or family history of migraine), that develop 3-6 h after the intake of nitrates, with debilitating, long-lasting symptoms including nausea, vomiting, photo-and/or phono-phobia. These two types of headaches are remarkably different, not only in their timing and symptoms, but also in the persons who are at risk. Recent studies provide evidence that the two headache types are caused by different mechanisms: immediate headaches are connected to vasodilation caused by nitric oxide (NO) release, while migraines are triggered by other actions such as the release of calcitonin gene-related peptide or glutamate, or changes in ion channel function mediated by cyclic guanosine monophosphate or S-nitrosylation. Migraines usually need anti-attack medication, such as triptans, but these drugs are contraindicated in most medical conditions that are treated using nitrates. In conclusion, these data recommend the correction of summaries of nitrate product characteristics, and also suggest a need to develop new types of anti-migraine drugs, effective in migraine attacks, that could be used in patients with risk for angina pectoris.

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Section: Different Nitrate Preparations and The Frequency Of Headachementioning

confidence: 99%

Headache‐type adverse effects of NO donors: vasodilation and beyond

Bagdy

Riba

Kecskeméti

et al. 2010

British J Pharmacology

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“…Similarly unconvincing results have been reported with ethaverine7 (the ethyl analogue of papaverine), vitamin E (alpha tocopherol),8 9 mannitol hexanitrate,4 and erythrol tetranitrate.4 Pentaerythritol tetra-nitrate, used originally by Bjdrlov,'0 has been regarded favourably by some authors1' 12 and less so by others. "3 14 The usefulness of khellin'5 is limited by the gastric disturbance which it often provokes: this is said to be less severe with pure crystalline preparations. "1 Vomiting is not due solely to local irritation, since it occurs also after intramuscular injection.…”

Section: Foetal Hepatitismentioning

confidence: 99%