Exertional angina is diagnosed in a 60-year-old Caucasian male. Metoprolol, isosorbide dinitrate, and aspirin are part of his treatment plan. He takes isosorbide dinitrate in the morning and again in the afternoon, but not in the evening. Such a pattern of drug administration is intended to decrease which of the following?

Question

Quizplus · Accepted Answer

Eductional Objective: Nitrate tolerance develops quickly when nitrates are administered continuously (in any form). This is why, in patients taking daily long acting nitrates, a nitrate-free interval must be provided every day. The mechanism by which this occurs is unknown, but it is thought to be due to decreased vascular sensitivity to nitrates and increased sensitivity to endogenous vasoconstricting agents. The nitrate-free period is usually scheduled during the night, when the patient is sleeping and cardiac work is at its lowest.

Exertional Angina Is Diagnosed in a 60-Year-Old Caucasian Male