title: Pain scoring--a method for assessing acute antianginal therapy comparison of the response to acute sublingual administration of an isosorbide dinitrate tablet, isosorbide dinitrate spray and nitroglycerin spray in unstable angina.
abstract: It is difficult to assess acute therapeutic intervention therapy, particularly in patients with unstable angina. Our aim was to evaluate the feasibility of a pain-scoring method and to compare the response to sublingual administration of an isosorbide dinitrate (ISDN) tablet, ISDN spray or nitroglycerin (NTG) spray. Pain scoring was assessed by the subjective grading of the patients' pain severity from 1 to 10. We studied 205 patients (mean age 66 +/- 13 years). Pain attenuation, defined as at least 50% reduction in pain intensity, occurred in the ISDN tablet, ISDN spray and NTG spray groups after 360 +/- 290, 318 +/- 289 and 233 +/- 271 s, respectively (p = 0.0005). In conclusion, pain scoring is a feasible and useful clinical method to assess antianginal therapy in unstable angina patients. Sublingual nitrate sprays, particularly NTG, seem to alleviate anginal pain faster than ISDN tablets in this patient population.
authors.affiliation: Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shotan
authors.forename: Z
authors.initials: Z
authors.lastname: Brill
authors.forename: S
authors.initials: S
authors.lastname: Matetzky
authors.forename: A
authors.initials: A
authors.lastname: Shachar
authors.forename: Z
authors.initials: Z
authors.lastname: Feigenberger
authors.forename: H
authors.initials: H
authors.lastname: Hod
authors.forename: E
authors.initials: E
authors.lastname: Kaplinsky
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications / Q000188:drug therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000627:therapeutic use; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin; D007548:Isosorbide Dinitrate