Compliance as a Factor in the Development of Nitrate Tolerance: A Patient Investigation

1993 ◽  
Vol 21 (1) ◽  
pp. 51-57 ◽  
Author(s):  
P Löfdahl
Keyword(s):  
Angina Pectoris ◽  
Nitrate Concentration ◽  
Nitrate Tolerance ◽  
Isosorbide Mononitrate ◽  
Dosing Regimen ◽  
Once Daily ◽  
Telephone Interviews ◽  
The Times ◽  
Plasma Nitrate ◽  
Long Acting

Telephone interviews were conducted to establish the prescribing instructions given by experienced physicians to patients with angina pectoris treated with long-acting nitrates. In addition, the times of day when doses were taken were recorded. The aim of the study was to determine whether or not an asymmetric dosing regimen was being followed by the patients. The majority (62.7%) of patients were being treated with 5-isosorbide mononitrate taken orally twice daily. All but two took the correct number of tablets, but more than 50% of these patients were not taking the second tablet at the correct time to achieve the recommended 6 − 8-h period during which the plasma nitrate concentration was sufficiently low to avoid nitrate tolerance. Possible explanations for the incorrect use of the prescribed drug may be that the patients did not understand the physician's instructions and did not appreciate the importance of rigidly adhering to these instructions. A more satisfactory approach, with improved patient compliance, may be a once-daily dosing regimen.

Comparison of therapy augmentation and deviation rates from the recommended once-daily dosing regimen between LDX and commonly prescribed long-acting stimulants for the treatment of ADHD in youth and adults

2013 ◽  
Vol 16 (10) ◽  
pp. 1203-1215 ◽  
Author(s):  
Juliana Setyawan ◽  
Paul Hodgkins ◽  
Annie Guérin ◽  
Geneviève Gauthier ◽  
Martin Cloutier ◽  
...  
Keyword(s):  
Dosing Regimen ◽  
Once Daily ◽  
Long Acting

Patient Compliance with Once-Daily and Twice-daily Oral Formulations of 5-Isosorbide Mononitrate: A Comparative Study

1994 ◽  
Vol 22 (5) ◽  
pp. 266-272 ◽  
Author(s):  
J Brun
Keyword(s):  
Angina Pectoris ◽  
Patient Compliance ◽  
Isosorbide Mononitrate ◽  
Daily Regimen ◽  
Stable Angina Pectoris ◽  
Event Monitoring ◽  
Release Formulation ◽  
Once Daily ◽  
Oral Formulations ◽  
To Receive

This study compares patient compliance with once- and twice-daily formulations of 5-isosorbide mononitrate. A total of 31 patients (20 men and 11 women) with stable angina pectoris were randomized to receive either 60 mg 5-isosorbide mononitrate in a controlled release formulation once daily, or 20 mg 5-isosorbide mononitrate twice daily. The results indicated that compliance assessed using the electronic Medication Event Monitoring System (MEMS®) was better with the once-daily than with the twice-daily formulation; patients on the once-daily regimen performed better with respect to the total number of bottle openings, the number of openings per day, the timing of openings and the intervals between openings. The apparently superior compliance with the once-daily regimen appeared to be reflected in better efficacy; patients on the once-daily regimen experienced fewer angina attacks (a mean of 1.7 per 7 days, compared with 3.3 per 7 days for patients on the twice-daily regimen) and used fewer nitroglycerin tablets than those on the twice-daily regimen.

Evaluation of Low-Dose Gentamicin Once Daily Dosing Regimen at A General Hospital in Malaysia

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Ab Rahman A F ◽  
Md Sahak N. ◽  
Ali A. M.
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Low Dose ◽  
Dosing Regimen ◽  
Once Daily ◽  
Neutropenic Sepsis ◽  
Wide Acceptance ◽  
The Mean ◽  
Initiation Of Therapy ◽  
Almost All

Objective: Once daily dosing (ODD) aminoglycoside is gaining wide acceptance as an alternative way of dosing. In our setting it is the regimen of choice whenever gentamicin is indicated. The objective of this study was to evaluate the practice of gentamicin ODD in a public hospital in Malaysia. Methods: We conducted a retrospective review of medical records of patients on gentamicin ODD who were admitted to Hospital Melaka during January 2002 until March 2010. All adult patients who were on ODD gentamicin with various level of renal function were included in the study. Patients on gentamicin less than 72 hours and pregnant women were excluded. Results: From 110 patients, 75 (68.2%) were male and 35 (31.8%) were female. Indications for ODD gentamicin included pneumonia, 34 (31.0%) neutropenic sepsis, 27 (24.5%) and sepsis, 11 (10.0%). The mean dose and duration of gentamicin was 3.2 mg/kg/day and 7 days, respectively. Almost all patients were on gentamicin combined with other antibiotics. Clinical cure based on fever resolution was found in 89.1% of patients treated with ODD. Resolution of fever took an average of 48 hours after initiation of therapy. The evaluation for bacteriologic cure could not be performed because of insufficient data on culture and sensitivity. Out of 38 patients with analyzable serum creatinine data, four patients might have developed nephrotoxicity. Conclusion: In our setting, lower dosages of ODD gentamicin when used in combination with other antibiotics seemed to be effective and safe in treating most gram negative infections.

A comparison of once daily bisoprolol, 5 and 10 mg, and atenolol 100 mg in the treatment of angina pectoris

1987 ◽  
Vol 8 (suppl M) ◽  
pp. 37-42 ◽  
Author(s):  
M. B. Maltz ◽  
D. S. Dymond ◽  
A. W. Nathan ◽  
A. J. Camm
Keyword(s):  
Angina Pectoris ◽  
Once Daily

scholarly journals Nicorandil and Long-acting Nitrates: Vasodilator Therapies for the Management of Chronic Stable Angina Pectoris

2018 ◽  
Vol 13 (1) ◽  
pp. 23 ◽  
Author(s):  
Jason M Tarkin ◽  
Juan Carlos Kaski ◽  
◽  
◽  
Keyword(s):  
Angina Pectoris ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Systemic Blood Pressure ◽  
Signalling Pathways ◽  
Stable Angina Pectoris ◽  
Systemic Blood ◽  
Long Acting ◽  
Chronic Use ◽  
Modest Reduction

Nicorandil and long-acting nitrates are vasodilatory drugs used commonly in the management of chronic stable angina pectoris. Both nicorandil and long-acting nitrates exert anti-angina properties via activation of nitric oxide (NO) signalling pathways, triggering vascular smooth muscle cell relaxation. Nicorandil has additional actions as an arterial K+ATP channel agonist, resulting in more “balanced” arterial and venous vasodilatation than nitrates. Ultimately, these drugs prevent angina symptoms through reductions in preload and diastolic wall tension and, to a lesser extent, epicardial coronary artery dilatation and lowering of systemic blood pressure. While there is some evidence to suggest a modest reduction in cardiovascular events among patients with stable angina treated with nicorandil compared to placebo, this prognostic benefit has yet to be proven conclusively. In contrast, there is emerging evidence to suggest that chronic use of long-acting nitrates might cause endothelial dysfunction and increased cardiovascular risk in some patients.

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