To prevent attacks of angina, isosorbide dinitrate is given typically at doses o

Question

To prevent attacks of angina, isosorbide dinitrate is given typically at doses of 120 mg/day, divided into three separate doses.
For one week’s regimen, how many 10-mg sublingual tablets of isosorbide dinitrate will be needed?

To prevent attacks of angina, isosorbide mononitrate is given twice daily typically at doses of 20 mg. It is administered at specific times, such as 8 AM and 3 PM, to prevent nitrate tolerance, which causes the drug to be less effective. How many 10-mg tablets are required for 30 days of treatment?

Nitroglycerin is administered by IV infusion in emergency situations. A typical infusion dose is 5 micrograms per minute. For a diluted nitroglycerin solution with a concentration of 100 micrograms per milliliter, what is the infusion rate in milliliters per hour?

For acute angina attacks, sublingual nitroglycerin is often used. By placing a tablet under the tongue, relief can be obtained within 5 minutes. As many as three doses can be administered in a 15-minute period, after which medical attention is recommended. The dose of nitroglycerin per tablet is 0.6 mg. What is the total dose of nitroglycerin that can be safely administered in 15 minutes?

Explanation / Answer

Adult Dose for Angina pectoris prophylaxis:

Isosorbide dinitrate:

Initial dose:

120mg/day divided into three separate doses.

Therefore 40mg sublingually each time for three times a day.

Maintenance Dose:

10mg of isosorbide dinitrate sublingually for one week.

So, 10mg of isosorbide dinitrate 3 times a day.( per day 3 tablets. for 7 days 7*3 = 21 tablets).

Therefore for one-week regimen 21 tablets of 10mg isosorbide dinitrate is required.

Isosorbide mononitrate:

Initial dose:

20mg twice daily at 8 am and 3 PM.

Maintenance Dose:

10mg for 30 days.

So, 10mg to be given at 8 am and 3 pm each day.(2tablets per day).

For 30 days 30*2 = 60

Therefore 60 number of 10mg isosorbide mononitrate tablets is required for 30 days regimen.

Nitroglycerine infusion:

Infusion Dose 5 microgram per minute.

Diluted Nitroglycerine solution has 100 micrograms per mililiter.

The infusion rate is

Step 1: convert the microgram /min to the milligram/ hr.

the formula is mcg/1000 * 60

Step 2: convert the ordered dose:

The ordered dose is 5mcg per min

5/1000 * 60 = 0.3 mg /hr

Step 3: Convert the available dose into mg/mL.

The available dose 100mcg/ml

100/1000*60 = 6mg/ml.

Step 4: calculate IV dosage formula.

Dose ordered/ Dose available* volume available = infusion rate

0.3/6 * 1 ml = 0.05mL/hr.

Therefore the Nitroglycerine IV infusion rate is 0.05ml/hr.

Nitroglycerine Sublingual Tablet Administration:

The safe use of Nitroglycerine is 0.3 to 0.6mg can be administered sublingually at 5 minutes interval up to 3 doses in 15 minutes. If the chest pain still persists immediate medical attention should seek.

Note:

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