New Application for Old Drug

Nitroglycerin is proving of value not only for the treatment of angina pectoris, but also for patients with myocardial infarction. When given by carefully controlled intravenous infusion, nitroglycerin has improved left ventricular function and compliance in a number of patients with acute myocardial infarction and moderate-to-severe left ventricular failure during the first 24 hours of therapy in intensive care units. According to Flaherty et al,¹the action of the drug may be based on the lowering of peripheral resistance. Flaherty also noticed that intravenous nitroglycerin decreased the heart rate. Kaplan et al²report that nitroglycerin infused intravenously normalized blood pressure in 20 hypertensive patients during coronary artery surgery. The mean dose of nitroglycerin was 80.0±4.7μg/min, or 0.96μg/kg/min. The drug substantially decreased systolic, diastolic, and mean arterial blood pressures, central venous pressure, pulmonary capillary wedge pressure, systemic vascular resistance, and left ventricular stroke work index. Flaherty et al¹