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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Isosorbide dinitrate is a medication used for heart failure, esophageal spasms, and to treat and prevent chest pain from not enough blood flow to the heart. [1] It has been found to be particularly useful in heart failure due to systolic dysfunction together with hydralazine. [2] [1] It is taken by mouth or under the tongue. [1]
A nitrovasodilator is a pharmaceutical agent that causes vasodilation (widening of blood vessels) by donation of nitric oxide (NO), [1] and is mostly used for the treatment and prevention of angina pectoris.
Isosorbide mononitrate, sold under many brand names, is a medication used for heart-related chest pain , heart failure and esophageal spasms. [2] It can be used both to treat and to prevent heart-related chest pain; however, it is generally less preferred than beta blockers or calcium channel blockers. [2] It is taken by mouth. [2]
By nitration of isosorbide with concentrated nitric acid, 2,5-isosorbide dinitrate (ISDN) can be obtained. 2,5-isosorbide dinitrate is suitable (just like its major metabolite 5-isosorbide mononitrate, ISMN [6]) for the treatment of angina pectoris due to its vasodilator effect. [7]
An antianginal is a drug used in the treatment of angina pectoris, a symptom of ischaemic heart disease.. Myocardial ischemia arises from the dysfunction of coronary macrovascular or microvascular components, leading to a compromised supply of oxygen and nutrients to the myocardium.
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The first CINODs were developed in the 1990s, and as yet none have been approved for use by the general public. The importance of developing such drugs was increased when COX-2-specific NSAIDs rofecoxib (Vioxx) and lumiracoxib (Prexige) were removed from major pharmaceutical markets in the mid-2000s due to vascular safety concerns.
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