[Peripheral effects of nitrate compounds (author's transl)].
Nitroglycerin primarily acts on smooth muscle fibers, and this effect is dose-dependent. High doses seem to affect mainly coronary blood flow; moderate doses act on both systemic arterial blood flow (resistance vascular bed) and return venous blood flow (capacitance vascular bed), while low doses influence only the latter. These various modes of action account for the discrepancies observed between the results of experimental studies, the final effect being the algebraical resultant of combined individual actions. In coronary insufficiency, where treatment aims at reducing myocardial oxygen consumption without lowering coronary perfusion pressure, nitroglycerin should be given in low doses. In congestive heart failure, where the primary target is reduction in preload and, consequently, heart work without excessive reduction in afterload that would result in decreased stroke index through Frank-Starling's mechanism, a detailed knowledge of the physiological mechanisms involved is required to guide nitroglycerin treatment.
D000787:Angina Pectoris / Q000503:physiopathology; D001158:Arteries / Q000187:drug effects; D006333:Heart Failure / Q000503:physiopathology; D009131:Muscle, Smooth, Vascular / Q000187:drug effects; D009206:Myocardium / Q000378:metabolism; D005996:Nitroglycerin / Q000031:analogs & derivatives* / Q000494:pharmacology*; D010101:Oxygen Consumption / Q000187:drug effects; D014680:Veins / Q000187:drug effects
D005996:Nitroglycerin
Effets périphériques des dérivés nitrés.