What is Which of the following drug can be used for prophylaxis as well as for the treatment of angina? and explain in detail?
Isosorbide dinitrate can be used for prophylaxis as well as for the treatment of angina pectoris.
Isosorbide dinitrate: It is a solid but similar in properties to GTN; can be used sublingually at the time of attack (slightly slower in action than GTN, peak in 5-8 min) as well as orally for chronic prophylaxis. Presystemic metabolism on oral administration is pronounced and variable. The t½ is 40 min, but sustained release formulation may afford protection for 6-10 hours. Last dose should not be taken later than 6 PM to allow nitrate level to fall during sleep at night.
Administration of isosorbide mononitrate:
(typically starting at 20 mg) Once or twice daily (in the latter case, with the doses administered 7 hours apart) is efficacious in the treatment of chronic angina, and once-daily dosing or an eccentric twice-daily dosing schedule can minimize the development of tolerance.
Reference: Essentials of Medical Pharmacology Eighth Edition KD  TRIPATHI  page no 589,590