NEWS HIGHLIGHTS
Published Studies Related to Nitroglycerin Transdermal
Cost-effectiveness of transdermal nitroglycerin use for preterm labor. [2011.03] OBJECTIVE: The objective of this study was to determine the cost-effectiveness of using transdermal nitroglycerin (GTN) for cases of preterm labor... CONCLUSION: The use of GTN patch for preterm labor could reduce NICU costs, while improving important neonatal outcomes. Copyright (c) 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Coadministration of atorvastatin prevents nitroglycerin-induced endothelial dysfunction and nitrate tolerance in healthy humans. [2011.01.04] OBJECTIVES: We aimed to assess whether concurrent administration of atorvastatin would modify the development of tolerance and endothelial dysfunction associated with sustained nitroglycerin (GTN) therapy in humans. BACKGROUND: Animal studies have demonstrated that administration of 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitors can protect against GTN-induced endothelial dysfunction and tolerance, likely through an antioxidant mechanism... CONCLUSIONS: The present findings demonstrate, for the first time in humans, that atorvastatin prevents both GTN-induced endothelial dysfunction and nitrate tolerance, likely by counteracting the GTN-induced increase in oxidative stress. Copyright (c) 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Maternal transdermal nitroglycerin use and early childhood development. [2010.12] OBJECTIVE: Our randomized, double-blind, placebo-controlled trial of transdermal nitroglycerin (GTN) for preterm labour demonstrated a significant reduction in neonatal morbidity and mortality. The objective of this study was to evaluate developmental performance in the children born to women who participated in the GTN trial after one year and two years of follow-up... CONCLUSION: Maternal GTN use for preterm labour had no impact on children's long-term development, but larger studies are needed to confirm the preliminary findings of this study.
Secondary analysis of the use of transdermal nitroglycerin for preterm labor. [2010.12] OBJECTIVE: This secondary analysis of a randomized placebo-controlled trial was to hypothesize on mechanisms for the improved neonatal outcomes with the use of nitroglycerin (GTN) for preterm labor... CONCLUSION: We hypothesize that GTN has a gestational age-dependent reduction in neonatal outcomes as a result of pregnancy prolongation and corticosteroid administration. Copyright (c) 2010 Mosby, Inc. All rights reserved.
Is transdermal nitroglycerin application effective in preventing and healing flap ischaemia after modified radical mastectomy? [2010.11] OBJECTIVE: We evaluated the efficacy of local nitroglycerin application in preventing and treating flap complications after modified radical mastectomy in a large patient cohort... CONCLUSION: Our results indicate that topical nitroglycerin reduces flap complications after breast surgery.
Clinical Trials Related to Nitroglycerin Transdermal
MQX-503 Applied to the Hand Versus Nitroglycerin Ointment Applied to the Chest: A Pharmacokinetic Comparison [Recruiting]
Nitroglycerin in Non-small Cell Lung Cancer [Recruiting]
Nitroglycerin is a nitric oxide donor which is mainly known as a vasodilating agent used in
ischemic heart disease. It has also been shown to increase tumor blood flow in animal and
human tumors.
The addition of nitroglycerin to chemotherapy in non small cell lung cancer has been shown
to generate very favorable response rates with respect to standard treatment schedules[5].
Theoretically nitroglycerin might reduce resistance to chemotherapy via a plethora of
different effects: better tumor perfusion, direct effects of NO on cancer cells, increase in
activated p53 protein and via an increased blood flow in the tumour with as consequence a
higher drug concentration in the tumor [6] .
In mice, nitric oxide donors such as isosorbide dinitrate have been shown to decrease tumor
hypoxia by better tumor perfusion, which could enhance radiotherapy responses [7].
To date these combined effects have not been tested in humans. In this trial we would like
to demonstrate the effect of nitroglycerin on tumor perfusion and hypoxia in non small cell
lung cancer (using DCE and HX4 scanning), providing a rationale for further study and to
test the effect of combining nitroglycerine to standard treatment of NSCLC
(radiotherapy/chemotherapy).
Treatment of Suspected Cholelithiasis With Nitroglycerin [Not yet recruiting]
ABSTRACT: Sublingual nitroglycerin has been advocated for the treatment of acute pain from
suspected symptomatic cholelithiasis. There is, however, no clinical studies that validate
its use. This study is designed to evaluate the efficacy of nitroglycerine in relieving
acute pain of suspected biliary tract origin.
Nitroglycerin is a potent smooth muscle relaxant used for biliary tract dilation during
ERCP, (Chelly, J) and has been recommended for treatment of biliary colic based on
anecdotal experience and small case reports. Nitroglycerin effect is a result of the nitric
oxide component of the medication which acts as a smooth muscle relaxant in vascular,
bronchial, esophageal and biliary smooth muscles. [McGowan(1936), Chelly (1979),Toyoyama
(2001)] The typical dose of nitroglycerin is 0. 4 mg given sublingually in pill form or,
more recently, in a metered spray form. In a case series reported by Hassel (1993), positive
response times ranged from 20 to 60 seconds with duration of action of two to twelve hours.
Sublingual nitroglycerin is most commonly used for treatment of chest pain related to
insufficient cardiac perfusion. It has also been noted to relieve the pain of esophageal
spasms. Nitroglycerin has an excellent safety profile if used in patients with adequate
pretreatment blood pressures. [Newberry (2005), Nitroglycerine (2011), Nitro (2011), Wolters
(2009)] This study proposes to compare sublingual 0. 4 mg doses of nitroglycerin to placebo
for the initial treatment of acute pain from suspected symptomatic cholelithiasis
GTN Therapy on Biomarkers of Immune Escape in Men With Biochemical Recurrence of Prostate Cancer After Primary Therapy [Recruiting]
Prostate cancer is the most commonly diagnosed cancer in men in Canada. Over 30% of men
over the age of fifty have histological evidence of prostate cancer on biopsy. Despite the
stage migration afforded by early detection with serum prostate specific antigen (PSA)
testing and an apparent trend toward improved survival over the past several years, prostate
cancer remains a significant cause of morbidity and mortality. Biochemical failure after
primary therapy (surgery or radiation) remains a significant health care burden and
strategies to delay clinical prostate cancer progression and prolong the interval from
treatment failure to systemic therapy would be of significant clinical benefit for those men
suffering from a finding of PSA recurrence.
PSA is widely accepted as the most useful prognostic marker of prostate cancer progression,
particularly after primary therapy with radical surgery or radiation. 5 Despite improved
cancer control rates with definitive management of early stage prostate cancer, a PSA
recurrence is unfortunately a common occurrence (25-50%) in most large case series.
Microenvironmental factors have been demonstrated to play a pivotal role in the selection of
neoplastic cell subpopulations expressing more malignant phenotypes and contributing to the
progression of localized and metastatic disease. Very low levels of O2 (< 10 mmHg) has been
well described in many solid tumours (including prostate cancer) and the extent of hypoxia
has been demonstrated to represent an independent marker of a poor prognosis for patients
with various types of cancers. Tumour hypoxia contributes to numerous adaptive phenotypes
including increased invasion and metastasis, as well as evasion of immune cell surveillance
increased resistance to radiotherapy and chemotherapy. Although cellular adaptive responses
to hypoxia are likely mediated by various mechanisms, our previous preclinical studies
suggest that decreased nitric oxide (NO)-dependent signalling plays a significant role in
this progression of a malignant phenotype.
The Effect of Nitroglycerin on the Intrauterine Device (IUD) Insertion Experience in Nulliparous Women [Recruiting]
Increasing ease of access of long-acting birth control methods, like intrauterine devices
(IUDs), is an important way to reduce the risk of unintended pregnancy. Unfortunately, fear
of IUD insertion in women who have not had children is common among health care providers
and women alike, and this limits IUD use. To increase acceptance of this highly effective
birth control method, there is a need to explore new, low cost, and easily applied methods
to improve the insertion experience. This is a pilot study to evaluate the effectiveness and
acceptability of nitroglycerin ointment applied vaginally to improve the IUD insertion
experience for both patient and provider. The investigators hypothesis is that nitroglycerin
ointment will decrease the pain associated with IUD insertion.
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