Organic nitrates can lead to the development of tolerance when used chronically. Which of the following preparations is least likely to develop tolerance:
Tolerance develops to nitrates, when these are present constantly in the blood. Sublingual route leads to immediate action of nitrates and these act for a sho time. Other preparations mentioned in the question are more likely to give consistent plasma levels of nitrates leading to development of tolerance.
Sustained release oral nitroglycerine
Sublingual nitroglycerine
Transdermal nitroglycerine
Oral pentaerythritol tetranitrate
CHF, Angina Pectoris and Myocardial Infarction