Summary
The effects of nitroglycerin, infused intravenously at 3.4 and 7.5 µg/min over 30 min, on haemodynamic parameters were determined in the morning and the afternoon in a randomized, placebo-controlled study in 5 healthy volunteers. The mean steady-state concentrations of nitroglycerin reached in the plasma during the infusions of 3.4 and 7.5 µg/min were 0.35±0.06 ng/ml and 0.64±0.22 ng/ml, respectively. Wide inter-individual variation was noted. The nitroglycerin-induced increase in the orthostatic rise in heart rate and the change in digital-pulse-wave morphology roughly paralleled the plasma concentration, whereas the reduction in systolic blood pressure in the upright position was still evident 15 mins after the infusion, i.e. when nitroglycerin was no longer measurable in plasma. No significant diurnal variation in vascular sensitivity to the vasodilative action of nitroglycerin was demonstrable. The change in pulse-wave morphology resulting from the reduction in peripheral resistance (shift of the dicrotic wave in the descending limb towards the base-line) proved to be the most sensitive haemodynamic parameter.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Christensen B, Nordenfelt I, Westling H, White T (1969) Intravenous infusion of nitroglycerin in normal subjects. Scand J Clin Lab Invest 23: 49–53
Flaherty JT, Come PC, Baird MD, Rouleau J, Taylor DR, Weisfeldt ML, Greene HL, Becker LC, Pitt B (1976) Effects of intravenous nitroglycerin on left ventricular function and ST segment changes in acute myocardial infarction. Br Heart J 38: 612–621
Hergott L, Amsterdam EA, Klein R, Licht J, Joye JA, DeMaria AN, Mason DT (1979) Hemodynamic effects of intravenous nitroglycerin compared to nitroprusside in acute cardiac failure. Clin Res 27: 16A
Strauer BE, Scherpe A (1978) Ventricular function and coronary hemodynamics after intravenous nitroglycerin in coronary artery disease. Am Heart J 95: 210–219
Armstrong PW, Armstrong JA, Marks GS (1980) Pharmacokinetic-hemodynamic studies of intravenous nitroglycerin in congestive cardiac failure. Circulation 62: 160–166
Armstrong PW, Armstrong JA, Marks GS (1980) Plasma nitroglycerin gradient during intravenous infusion in man. Circulation 62: 111–326; Clin Res 28: 662A
Oh VMS, Reid PR (1979) Pharmacodynamic studies after intravenous trinitroglycerin. Pharmacologist 21: 202 (Abstr)
Oh VMS, Reid PR Pharmacodynamic studies following intravenous trinitroglycerin. Clin Res 27: 191 A (Abstr)
Wei JY, Reid PR (1979) Quantitative determination of trinitroglycerin in human plasma. Circulation 59: 588–592
McNiff EF, Yacobi A, Young-Chang FM, Golden LH, Goldfarb A, Fung H-L (1981) Nitroglycerin pharmacokinetics after intravenous infusion in normal subjects. J Pharm Sci 70: 1054–1058
Imhof PR, Ott B, Fankhauser P, Chu L-C, Hodler J (1980) Difference in nitroglycerin dose-response in the venous and arterial beds. Eur J Clin Pharmacol 18: 455–460
Imhof PR, Ott B, Weiss A, Chu L-C, Chasseaud LR (1981) Plasma concentrations and hemodynamic effects of percutaneously administered nitroglycerin and isosorbide dinitrate in healthy volunteers. In: Lichtlen PR, Engel HJ, Schrey A, Swan HJC (eds), Nitrates III. Cardiovascular Effects. Springer, Berlin Heidelberg New York, pp 66–74
Yap PSK, McNiff EF, Fung H-L (1978) An improved GLC assay for the determination of nitroglycerin in plasma. J Pharm Sci 67: 582–584
Gérardin A, Gaudry D, Wantiez D (1982) Gas-chromatography mass-spectrometry determination of 1, 2, 3-propanetriol-trinitrate (nitroglycerin) in human plasma using the nitrogen-15 labelled compound as internal standard. Biom Mass Spectrom (in press)
Müller Ph, Imhof PR, Burkart F, Chu L-C, Gérardin A (1982) Human pharmacological studies of a new transdermal system containing nitroglycerin. Eur J Clin Pharmacol (in press)
Baaske DM, Ammann AH, Wagenknecht DM, Mooers M, Carter JE, Hoyt HJ, Stoll RG (1980) Nitroglycerin compatibility with intravenous fluid filters, containers, and administration sets. Am J Hosp Pharm 37:201–205
Branje, JPhA, Berghuis B (1980) Adsorption of NTG. Am Heart J 100:409–410
Ingram JK, Miller JD (1979) Plastic absorption adsorption of nitroglycerin in solution. Anesthesiology 51 [Suppl]:132
Sokoloski ThD, Wu C-C, Burkman AM (1980) Rapid adsorptive loss of nitroglycerin from aqueous solution to plastic. Int J Pharmaceut 6:63–76
Yuen P-H, Denman SL, Sokoloski ThD, Burkman AM (1979) Loss of nitroglycerin from aqueous solution into plastic intravenous delivery systems. J Pharm Sci 68:1163–1166
Brymer JF, Stetson PL, Walton JA, Lucchesi BR, Pitt B (1979) Correlation of hemodynamic effects and plasma levels of nitroglycerin. Clin Res 27:229A
Kamiya A, Fung HL (1981) In: Abstracts of papers presented before the APhA Academy of Pharmaceutical Sciences. 11:78 (quoted from Reference 10)
Armstrong JA, Slaughter SE, Marks GS, Armstrong PW (1980) Rapid disappearance of nitroglycerin following incubation with human blood. Can J Physiol Pharmacol 58:459–462
Packer M, Meller J, Medina N, Yushak M, Gorlin R (1981) Determinants of drug response in severe chronic heart failure. 1. Activation of vasoconstictor forces during vasodilator therapy. Circulation 64:506–514
Bussmann W-D, Schöfer H, Kurita A, Ganz W (1979) Nitroglycerin in acute myocardial infarction. X. Effect of small and large doses of nitroglycerin on sigma ST segment deviation.-Experimental and clinical results. Clin Cardiol 2:106–112
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Imhof, P.R., Sieber, A., Hodler, J. et al. Plasma concentrations and haemodynamic effects of nitroglycerin during and after intravenous infusion in healthy volunteers. Eur J Clin Pharmacol 23, 99–106 (1982). https://doi.org/10.1007/BF00545962
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00545962