TY - JOUR
T1 - Effect of Apparent Elimination Half-Life on Nitroglycerin-Induced Hemodynamic Rebound in Experimental Heart Failure
AU - Bauer, John Anthony
AU - Fung, Ho Leung
PY - 1993/9
Y1 - 1993/9
N2 - Hemodynamic rebound after abrupt withdrawal may be an important consideration associated with nitroglycerin (NTG) monotherapy. This phenomenon may arise from unopposed neurohormonal vasoconstriction because of rapid elimination of NTG. The role of NTG pharmacokinetics in the development of hemodynamic rebound was examined using a rat model of congestive heart failure. NTG was infused for 90 min, then the dose was either abruptly stopped (n = 8) or gradually reduced by 20% every 20 min (n = 7). Abrupt withdrawal caused rebound elevations of left ventricular end-diastolic pressure (LVEDP) to about 25% above baseline values, at 30–60 min after drug termination (P < 0.01), but this was completely avoided by graded NTG withdrawal. A positive correlation was observed (P < 0.05) between the percentage reduction in LVEDP during infusion and the maximum percentage rebound in rats after abrupt withdrawal but not after graded withdrawal. These results suggest that NTG-induced hemodynamic rebound is related to its short biological half-life and that this phenomenon is consistent with a mechanism of neurohormonal compensation.
AB - Hemodynamic rebound after abrupt withdrawal may be an important consideration associated with nitroglycerin (NTG) monotherapy. This phenomenon may arise from unopposed neurohormonal vasoconstriction because of rapid elimination of NTG. The role of NTG pharmacokinetics in the development of hemodynamic rebound was examined using a rat model of congestive heart failure. NTG was infused for 90 min, then the dose was either abruptly stopped (n = 8) or gradually reduced by 20% every 20 min (n = 7). Abrupt withdrawal caused rebound elevations of left ventricular end-diastolic pressure (LVEDP) to about 25% above baseline values, at 30–60 min after drug termination (P < 0.01), but this was completely avoided by graded NTG withdrawal. A positive correlation was observed (P < 0.05) between the percentage reduction in LVEDP during infusion and the maximum percentage rebound in rats after abrupt withdrawal but not after graded withdrawal. These results suggest that NTG-induced hemodynamic rebound is related to its short biological half-life and that this phenomenon is consistent with a mechanism of neurohormonal compensation.
KW - congestive heart failure
KW - hemodynamic rebound
KW - nitroglycerin
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U2 - 10.1023/A:1018930032203
DO - 10.1023/A:1018930032203
M3 - Article
C2 - 8234174
AN - SCOPUS:0027186163
SN - 0724-8741
VL - 10
SP - 1341
EP - 1345
JO - Pharmaceutical Research
JF - Pharmaceutical Research
IS - 9
ER -