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Pentaerithrityltetranitrat: Evidenzorientiertes Therapiekonzept Kardialer Erkrankungen

Pentaerithrityltetranitrat: Evidenzorientiertes Therapiekonzept Kardialer Erkrankungen

          
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About the Book

Organische Nitratester gehören seit über 120 Jahren zum therapeutischen Schatz der pharmakotherapeutischen Behandlung von ischämischen Herz- erkrankungen, insbesondere der koronaren Herzkrankheit (KHK). Sie gehören zu den ersten definierten Wirkstoffverbindungen überhaupt, die in der klini- schen Medizin angewendet wurden. Die Ansichten zu ihrer Wirksamkeit gehen seit genauso langer Zeit auseinander, obwohl der therapeutische Nutzen immer wieder - so auch in jüngster Zeit - beschrieben wurde und ihr Stellenwert in nationalen und internationalen Leitlinien definiert ist. Die kritische Diskussi- on wird im Wesentlichen durch zwei Gesichtspunkte stimuliert, die den klini- schen Einsatz von Nitrovasodilatatoren limitieren. Eine chronische Therapie mit dem am häufigsten untersuchten Glyceroltrinitrat (GTN) führt zu Wir- kungsabschwächung (Toleranz). Auf Grund neuerer Befunde ist dieses Phäno- men der Toleranz die Folge der durch GTN stimulierten verstärkten Bildung von Sauerstoffradikalen, die die NO-Bioverfügbarkeit vermindern und den Prozess der Atherogenese fördern. Für die Compliance des Patienten ist der mit der Therapie verbundene Nitratkopfschmerz ein ausgesprochen negativer Faktor. Die mit GTN erhobenen Befunde wurden in der Vergangenheit und werden auch heute noch immer wieder auf die gesamte Klasse übertragen. Dies ist, wie die Erfahrung mit anderen Substanzklassen (z. B. Ca-Antagonisten und Betarezeptoren-Blockern) eindeutig gezeigt hat, nicht nur wissenschaft- lich unzulässig, sondern auch ausgesprochen problematisch. Für den NO-Donor Pentaerithrityltetranitrat (PETN) konnte insbesondere im vergangenen Jahrzehnt durch methodisch einwandfreie Untersuchungen nachgewiesen werden, dass PETN weder im Tierexperiment noch unter hu- manpharmakologischen Bedingungen hämodynamische Toleranz auslöst. PETN führt auch nicht zu einer vermehrten Bildung von Sauerstoffradikalen. Daher bleibt die NO-Bioverfügbarkeit unter PETN ungestört erhalten.


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Product Details
  • ISBN-13: 9783798514898
  • Publisher: Steinkopff Darmstadt
  • Binding: Paperback
  • Height: 244 mm
  • No of Pages: 128
  • Spine Width: 7 mm
  • Weight: 231 gr
  • ISBN-10: 3798514895
  • Publisher Date: 02 Dec 2004
  • Edition: Softcover Reprint of the Origi ed.
  • Language: German
  • Returnable: N
  • Sub Title: Evidenzorientiertes Therapiekonzept Kardialer Erkrankungen
  • Width: 170 mm


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