Canadian Health&Care; Mall

Once an adequate response to a given dose of ISDN was obtained, the patient was instructed to take that dose three times daily and he was retested in 2 weeks. If there was no longer at least a 2-minute increase in exercise time following single administration of the same dose, a larger dose was tested, and if effective, it was administered for 2 weeks three times daily. To continue onto the next phase of the study, a patient had to demonstrate continued responsiveness following 2 weeks of ISDN administration. We generally stopped titration if there was primary or secondary failure to respond after the single dose had been increased to 40 mg, although one patient s condition eventually stabilized with a 60-mg dose. Nitroglycerin hitches After a patient had demonstrated continued responsiveness to nitrates during long-term ISDN administration, we attempted to obtain a similar response 1 to 1.5 hours following the short-term application of a dose of nitroglycerin patch. We generally started titration with three 20-sq cm patches and stopped when a good response had not been achieved by 140 sq cm. (Each 20 sq cm patch was designed to release 10 mg of nitroglycerin in 24 hours. Since the primary factor determining dose received by the patient is the amount of skin exposed to nitroglycerin, we prefer to indicate doses in square centimeters.)