Best time to administer long term nitrates for nocturnal angina: September 2011
Ans. C: Evening If nocturnal angina is a predominant symptom, long term nitrates can be given at the end of the day Nitrates: They cause vasodilation, flushing, headache, dizziness, met-hemoglobinemia Decreases preload and afterload Decreases myocardial oxygen consumption Causes reflex tachycardia, hypotension Long acting nitrates are not used chronically as tolerance develops *Shoest acting NITRITE: Amyl nitrite Shoest acting nitrate: Nitroglycerine Longest acting nitrate: Penta-erythritol-nitrate
Early morning
Noon
Evening
Late night