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Latest & greatest articles for nitroglycerin
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A meta-analysis for the effect of prophylactic GTN on the incidence of post-ERCP pancreatitis and on the successful rate of cannulation of bile ducts Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Topical glyceryltrinitrate for rotator cuff disease. Rotator cuff disease is a common cause of shoulder pain. Topical glyceryltrinitrate is a possible new treatment.To determine the effectiveness and safety of topical glyceryltrinitrate for rotator cuff disease.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, SPORTDiscus, PEDro, the Australian Clinical Trials Registry, Current Controlled Trials (to October 2007) and the references (...) and citations of included studies.We included randomised controlled trials and controlled clinical trials of people with rotator cuff disease who received topical glyceryltrinitrate, alone or in combination, compared to placebo or active therapy.Two authors independently assessed risk of bias and extracted data.Three small studies, one at moderate risk of bias and two at high risk of bias, were included. Meta-analysis was precluded due to different interventions and outcome measures. Study participants
MQX-503, a novel formulation of nitroglycerin, improves the severity of Raynaud`s phenomenon: A randomized, controlled trial Raynaud's phenomenon (RP) affects 3-9% of the general population and >90% of patients with systemic sclerosis. Nitrates are often prescribed for the treatment of RP, but currently available formulations are limited by side effects, particularly headaches, dizziness, and skin irritation. The purpose of this study was to evaluate the tolerability and efficacy of a novel (...) formulation of topical nitroglycerin, MQX-503, in the treatment of RP in an ambulatory setting.We conducted a multicenter, randomized, placebo-controlled study with a 2-week single-blind run-in period to determine baseline severity, followed by a 4-week double-blind treatment phase. Two hundred nineteen adult patients with a clinical diagnosis of primary or secondary RP received 0.9% MQX-503 gel or matching placebo during the treatment period. Gel was applied immediately before or within 5 minutes
Glyceryltrinitrate for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: a meta-analysis of randomized, double-blind, placebo-controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Randomized comparison of intravenous terbutaline vs nitroglycerin for acute intrapartum fetal resuscitation. The purpose of this study was to compare terbutaline and nitroglycerin for acute intrapartum fetal resuscitation.Women between 32-, 42 weeks' gestation were assigned randomly to 250 microg of terbutaline or 400 microg nitroglycerin intravenously for nonreassuring fetal heart rate tracings in labor. The rate of successful acute intrapartum fetal resuscitation and the maternal hemodynamic (...) changes were compared. Assuming a 50% failure rate in the terbutaline arm, we calculated that a total of 110 patients would be required to detect a 50% reduction in failure in the nitroglycerin group (50% to 25%), with an alpha value of .05, a beta value of .20, and a power of 80%.One hundred ten women had nonreassuring fetal heart rate tracings in labor; 57 women received terbutaline, and 53 women received nitroglycerin. Successful acute resuscitation rates were similar (terbutaline 71.9
Drugs - GlycerylTrinitrate (GTN and Suscard) GlycerylTrinitrate (GTN, Suscard) GTN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Metered dose spray containing 400 micrograms glyceryltrinitrate per dose. Tablets containing glyceryltrinitrate 2, 3 or 5 milligrams for buccal administration (depends on local ordering). ACTIONS A potent vasodilator drug resulting in: • dilatation of coronary arteries/relief of coronary spasm. • dilatation of systemic veins resulting in lower pre-load (...) effects are mainly related to a generalised vasodilation effect of this drug and are usually transient. GTNGlycerylTrinitrate (GTN, Suscard) Page 2 of 2 October 2006 Drugs Drugs
GlycerylTrinitrate (GTN and Suscard) GlycerylTrinitrate (GTN, Suscard) GTN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Metered dose spray containing 400 micrograms glyceryltrinitrate per dose. Tablets containing glyceryltrinitrate 2, 3 or 5 milligrams for buccal administration (depends on local ordering). ACTIONS A potent vasodilator drug resulting in: • dilatation of coronary arteries/relief of coronary spasm. • dilatation of systemic veins resulting in lower pre-load. • reduced (...) related to a generalised vasodilation effect of this drug and are usually transient. GTNGlycerylTrinitrate (GTN, Suscard) Page 2 of 2 October 2006 Drugs Drugs
Chest pain relief by nitroglycerin does not predict active coronary artery disease. The belief that chest pain relief with nitroglycerin indicates the presence of active coronary artery disease is common. However, this hypothesis has not been tested.To define the diagnostic and prognostic value of chest pain relief with nitroglycerin.Prospective observational cohort study.Urban community teaching hospital.459 consecutive patients with chest pain admitted through the emergency department who (...) received nitroglycerin from emergency services personnel or an emergency department nurse. Follow-up was obtained by telephone contact at 4 months.Chest pain relief was defined as a decrease of at least 50% in patients' self-reported pain within 5 minutes of the initial dose of sublingual or spray nitroglycerin. Active coronary artery disease was defined as any elevated serum enzyme levels, coronary angiography demonstrating a 70% or greater stenosis, or a positive exercise test result.Nitroglycerin
Nitroglycerin in septic shock after intravascular volume resuscitation. In patients with septic shock, oxygen consumption is increased, but oxygen delivery and extraction is impaired, partly because of microcirculatory shutdown and shunting. Orthogonal polarisation spectral (OPS) imaging allows visualisation of the microcirculation. We used this technique to assess microcirculatory flow in septic-shock patients who had a mean arterial blood pressure of more than 60 mm Hg and central venous (...) pressure greater than 12 mm Hg. The infusion of 0.5 mg of nitroglycerin intravenously then resulted in a marked increase in microvascular flow on OPS imaging. Improved recruitment of the microcirculation could be a new resuscitation endpoint in septic shock.
Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. Decompensated congestive heart failure (CHF) is the leading hospital discharge diagnosis in patients older than 65 years.To compare the efficacy and safety of intravenous nesiritide, intravenous nitroglycerin, and placebo.Randomized, double-blind trial of 489 inpatients with dyspnea at rest from decompensated CHF, including 246 who received pulmonary artery (...) catheterization, that was conducted at 55 community and academic hospitals between October 1999 and July 2000.Intravenous nesiritide (n = 204), intravenous nitroglycerin (n = 143), or placebo (n = 142) added to standard medications for 3 hours, followed by nesiritide (n = 278) or nitroglycerin (n = 216) added to standard medication for 24 hours.Change in pulmonary capillary wedge pressure (PCWP) among catheterized patients and patient self-evaluation of dyspnea at 3 hours after initiation of study drug among
Nitroglycerin as a uterine relaxant: a systematic review Nitroglycerin as a uterine relaxant: a systematic review Nitroglycerin as a uterine relaxant: a systematic review Morgan P J, Kung R, Tarshis J Authors' objectives To evaluate the effectiveness of nitroglycerin as a uterine relaxant. Searching The authors searched PubMed (from 1966 to 2001), the Cochrane Controlled Trials Register, the International Journal of Obstetric Anesthesia, and the reference lists of identified articles. They also (...) in the review Randomised controlled trials (RCTs) were eligible for the review. Two of the included studies used a crossover design. Specific interventions included in the review Studies using nitroglycerin as a uterine relaxant were potentially eligible. In the included studies, nitroglycerin was used in obstetrics and gynaecology for induction, version, foetal extraction, pre-eclampsia, tocolysis, cervical dilation, embryo transfer and dysmenorrhoea. The dose and application (intravenous, vaginal or skin
(Rectogesic) compared to lateral internal sphincterotomy in the United Kingdom Christie A, Guest J F Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of nitroglycerin (0.2% glycerine nitrate, GTN) (Rectogesic) for the treatment (...) Modelling the economic impact of managing a chronic anal fissure with a proprietary formulation of nitroglycerin (Rectogesic) compared to lateral internal sphincterotomy in the United Kingdom Modelling the economic impact of managing a chronic anal fissure with a proprietary formulation of nitroglycerin (Rectogesic) compared to lateral internal sphincterotomy in the United Kingdom Modelling the economic impact of managing a chronic anal fissure with a proprietary formulation of nitroglycerin
Nitroglycerin is preferable to diltiazem for prevention of coronary bypass conduit spasm Nitroglycerin is preferable to diltiazem for prevention of coronary bypass conduit spasm Nitroglycerin is preferable to diltiazem for prevention of coronary bypass conduit spasm Shapira O M, Alkon J D, Macron D S F, Keaney J F, Vita J A, Aldea G S, Shemin R J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The study focused on the use of two conduit vasodilators in the prevention of arterial conduit spasm after coronary bypass grafting (CABG). Patients received a 24-hour intravenous infusion of either nitroglycerin (0.1 microgram.kg-1.min-1) or diltiazem (0.1 mg/kg during 20 minutes and then 0.1 mg.kg-1.min-1), followed by 6 months
) 1999 Authors' objectives To assess the effectiveness and cost-effectiveness of glyceryltrinitrate for chronic anal fissures Authors' conclusions 0.2% glyceryltrinitrate (GTN) ointment is an unlicensed treatment for chronic anal fissures. The Committee agreed that GTN has a clinically important effect on healing and is a simple and cheap treatment. It often avoids the need for surgery, as well as the delay in waiting for surgical treatment. Evidence for the use of this treatment comes from 2 RCTs (...) Glyceryltrinitrate for chronic anal fissures Glyceryltrinitrate for chronic anal fissures Glyceryltrinitrate for chronic anal fissures Chase D, Milne R Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Chase D, Milne R. Glyceryltrinitrate for chronic anal fissures. Southampton: Wessex Institute for Health Research and Development (WIHRD
A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. Lateral internal sphincterotomy, the most common treatment for chronic anal fissure, may cause permanent injury to the anal sphincter, which can lead to fecal incontinence. We compared two nonsurgical treatments that avert the risk of fecal incontinence. We randomly assigned 50 adults with symptomatic chronic posterior anal fissures to receive treatment with either a total (...) of 20 U of botulinum toxin injected into the internal anal sphincter on each side of the anterior midline or 0.2 percent nitroglycerin ointment applied twice daily for six weeks.After two months, the fissures were healed in 24 of the 25 patients (96 percent) in the botulinum-toxin group and in 15 of the 25 (60 percent) in the nitroglycerin group (P=0.005). No patient in either group had fecal incontinence. At some time during treatment, five patients in the nitroglycerin group had transient
A randomised, prospective, double-blind, placebo-controlled trial of glyceryltrinitrate ointment in treatment of anal fissure. Anal fissure is most commonly treated surgically by internal anal sphincterotomy. However, there is some concern over the effects of this procedure on continence. Nitric oxide donors such as glyceryltrinitrate (GTN) have been shown to cause a reversible chemical sphincterotomy capable of healing fissures in a small series of cases. This study reports a prospective (...) , randomised, double-blind, placebo-controlled trial to test the hypothesis that topical GTN is the best first-line treatment for chronic anal fissure.80 consecutive patients were randomised to receive treatments with topical 0.2% GTN ointment or placebo. Maximum anal resting pressure (MARP) was measured with a constantly perfused side-hole catheter before and after the first application of trial ointment. Anodermal blood flow was measured during manometry by laser Doppler flowmetry. After initial
1997LancetControlled trial quality: predicted high
Randomised, double-blind trial of intravenous diltiazem versus glyceryltrinitrate for unstable angina pectoris. The effect of dihydropyridines in patients with unstable angina is discouraging. To find out the effect of the non-dihydropyridine-like calcium-channel blocker diltiazem, a randomised, double-blind trial was conducted comparing diltiazem with glyceryltrinitrate, both given intravenously, in 129 patients with unstable angina. The endpoints were refractory angina or myocardial (...) infarction, individually and as a composite endpoint. Refractory angina alone or together with myocardial infarction occurred significantly less commonly in the diltiazem group. While patients were on the trial drugs the numbers with refractory angina were 6 (10%) in the diltiazem group versus 17 (28%) in the glyceryltrinitrate group (relative risk 0.36, p = 0.02), and the numbers with refractory angina and myocardial infarction were 9 (15%) versus 23 (38%) (relative risk 0.40, p = 0.007). Over 48 h
combined with glyceryltrinitrate (TER-GTN), administered as early as possible to 76 patients with cirrhosis who had active GIB (84 bleeding episodes). Infusion was done at the patient's home by the physician on the emergency team (a mobile intensive care unit) if the patient had GIB and a history and clinical signs of cirrhosis. Patients received either an intravenous injection (1 to 2 mg) of TER-GTN or a double-placebo injection, and then another injection at 4 and 8 h. Control of bleeding (...) Early administration of terlipressin plus glyceryltrinitrate to control active upper gastrointestinal bleeding in cirrhotic patients. Upper gastrointestinal bleeding (GIB) is a major complication in cirrhotic patients. Endoscopy and oesophageal sclerosis are reference treatments and must be done as soon as possible. However, such treatment is not possible unless the patient is admitted to hospital. In a prospective, randomised, double-blind trial, we compared the efficacy of terlipressin
1995LancetControlled trial quality: predicted high
GISSI-3: effects of lisinopril and transdermal glyceryltrinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Gruppo Italiano per lo Studio della Sopravvivenza nell'infarto Miocardico. GISSI-3 is a multicentre randomised clinical trial to assess the efficacy of lisinopril, transdermal glyceryltrinitrate (GTN), and their combination in improving survival and ventricular function after acute myocardial infarction (AMI). Between June, 1991 (...) , and July, 1993, 19,394 patients were randomised from 200 coronary care units in Italy. Eligible patients presented within 24 h of symptom onset and had no clear indications for or against the study treatments. In a factorial design patients were randomly assigned 6 weeks of oral lisinopril (5 mg initial dose and then 10 mg daily) or open control as well as nitrates (intravenous for the first 24 h followed by transdermal GTN 10 mg daily) or open control. Complete clinical data and 6-week follow-up were
1994LancetControlled trial quality: predicted high
Quality of life on angina therapy: a randomised controlled trial of transdermal glyceryltrinitrate against placebo. In a randomised controlled trial in 427 men with chronic stable angina continuous use of 5 mg transdermal glyceryltrinitrate (GTN) showed no advantage over placebo in terms of efficacy (anginal attack rates and sublingual GTN consumption) or quality of life (as measured with the sickness impact profile and a health index of disability). Patients on the active drug reported (...) headaches more frequently than patients on placebo, and a higher proportion of them withdrew from the trial because of headache. Quality-of-life measurements showed a significant adverse effect of active treatment, principally in the social interaction dimension of the sickness impact profile. A similar effect was observed in placebo patients when crossed to active treatment in a 4-week single-blind period. The results suggest no benefit in the relief of chest pain from 5 mg transdermal GTN when used