18. ROUTES OF ADMINISTRATION 1. Sublingual route – rational and effective for the treatment of acute attacks of angina pectoris. Half-life depend only on the rate at which they are delivered to the liver. 2. Oral route – to provide convenient and prolonged prophylaxis against attacks of angina 3. Intravenous Route – useful in the treatment of coronary vasospasm and acute ischemic syndrome. 4. Topical route – used to provide gradual absorption of the drug for prolonged prophylactic purpose .
19. Drug Usual single dose Route of administration Duration of action Short acting Nitroglycerin 0.15-1.2 mg sublingual 10 - 30 min Isosorbide dinitrate 2.5-5 mg sublingual 10 – 60 min Amyl nitrite 0.18 – 3 ml inhalation 3 – 5 min Long acting Nitroglycerin sustained action 6.5 – 13 mg q 6-8 hrs oral 6 – 8 hrs Nitroglycerin 2% ointment 1 – 1.5 inches q hr topical 3 – 6 hrs Niroglycerin slow released 1 –2 mg per 4 hrs Buccal mucosa 3 – 6 hrs Nitroglycerin slow released 10 – 25 mg /24hrs (one patch/day} transdermal 8 –10 hrs Isosorbide dinitrate 2.5 – 10 mg per 2 hrs sublingual 1.5 – 2 hrs Isosorbide dinitrate 10 –60 mg per 4-6 hrs oral 4 – 6 hrs Isosorbide dinitrate chewable 5 – 10 mg per 2-4 hrs oral 2 – 3 hrs Isosorbide mononitrate 20 mg per 12 hrs oral 6 –10 hrs
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34. Type of Angina Other Names Description Drug Therapy STABLE Classic Exertional Fixed Atherosclerotic Obstruction coronary artery Nitrates CCB B-blockers VARIANT Prinzmetal’s Vasospasmic Vasospasm at any time Nitrates CCB UNSTABLE Crescendo Combined effect Pre= MI Nitrates CCB