Generic Sorbitrate

1. Denomination

Isordil, Sorbitrate

2. Active Substance

Isosorbide Dinitrate

3. Indications for Use.

Stenocardia (cessation and preventive measures of attacks), acute myocardial infarction, acute left ventricular failure, hypertension, backward heart failure.

4. Action

Under the influence of Isosorbide Dinitrate there comes relaxation of smooth muscles, arteries and veins. From the other hand, the drug has an obvious capacity to dilate coronary vessels and, thus, it increases the oxygen delivery to heart muscle.

5. Posology and Administration

Isosorbide Dinitrate should be taken orally, sublingually, intravenously, with inhalation, with skin application. In stenocardia: capsules and tablets — 5–20 mg each every 6 hours(if needed it may be taken up to 20–40 mg 4 times daily); dosage forms of durable action should be taken 40–80 mg every 8–12 hours (should be swallowed in whole); chewing tablets should be taken 5 mg each every 2–3 hours.
Sublingually it should be taken 2,5–5 mg each, if needed - every 2–3 hours.
In acute myocardial infarction and acute left ventricular failure the drug should be used intravenously: the starting dose is 1–2 mg/hour, the maximal dose is 8–10 mg/hour.
With inhalation in order to stop stenocardia attacks: it is necessary to spray 1–3 doses on the mouth cavity mucus coating with an interval of 30 seconds in a breath-holding spell.
Skin application -  1 g of cream/2 doses are to be applied on the skin surface.

6. Counterindications

Hypersensitivity, anemia, insult to the brain or recently had head injury, glaucoma, compromised function of thyroid gland, hypotension, pregnancy, breastfeeding (breastfeeding should be stopped), childhood.

7. Should Be Taken with Precautions, if…

With caution Isosorbide Dinitrate is administered to stroke patients; to high intracranial pressure patients, to hypotension-prone patients; to elderly people; to pregnant and breastfeeding women. In the period of treatment, especially in cases of gradual increase of a dose, control of arterial tension and frequency of heart beats is needed.

8. Interface with Other Medications

If there is a need of combination of drugs - approach your attending doctor on the matter of compatibility of medications.

9. Overdosing

Symptoms: cyanosis of lips and nails, severe dizziness or fainting fit, pressure sense in the head, weakness, labored breath, weak heartbeat and rapid heart, elevated temperature of the body, convulsions.

10. Side Effects

Flush, headache, dizziness, nausea, vomiting, heat sensation on the tip of the tongue, orthostatic hypotension, collapse, motor anxiety, stiffness, disorder of attention, tachycardia, withdrawal syndrome.

11. Pregnancy and Lactation

The use in the I-st trimester of pregnancy is counterindicated. Administration in the II-nd-III-d trimester of pregnancy is possible only on strict indications and under permanent medical control. During treatment breastfeeding should be stopped.

12. Driving

In the beginning of the treatment the people whose activity requires quick psychic and motion reactions should take a special care.

CORRECTING CONGENITAL DEFECTS IN CHILDREN
Surgery has ensured that the great majority of children born with seriously defective hearts will lives.
The diagnosticians, too, cannot be praised too highly – we no longer have to wait until a child is born before diagnosing a congenital heart defect. It is now possible to scan the heart of the baby in the womb, at no risk to mother or child, using sound waves of very high frequency -ultrasound. This technique is often called echocardiography. At Guy's Hospital in London, techniques have been pioneered to spot heart defects at around 16 to 18 weeks after conception. Initially only major malformations, such as valve disorders or wrong connections to the heart, could be detected in this way, but now the ultrasonic scanner is being used for a wider range of congenital problems.
If problems are detected, the parents have a choice: they may have the pregnancy terminated, or the mother can be taken to a specialist hospital with proper facilities for caring for the baby as soon as it is born.
Ultrasonic screening for congenital heart disease will almost certainly become a routine procedure. Not only will it help to provide early diagnosis but in some cases - for instance, that of arrhythmias in the foetus - it will enable doctors to treat their young patients before ever they see the light of day.
Parents of children with congenital heart defects often ask, worried that too much rushing around will overtax their child, if they should impose restrictions on day-to-day movements. The answer is 'no'. Human beings - yes, children too - are very good at knowing when enough is enough, when their bodies are approaching their limits. Unless there is a very specific reason for certain activities to be proscribed - and your doctor has already spelled this out to you - do not worry unduly about a child swimming, skating, cycling and playing ball-games. Not only will the activity do no harm, it will prevent the young heart-sufferer from feeling different from everyone else, from being treated like a delicate flower, and from thinking of himself or herself as in any way 'special'.
If you are the parent of a child with a congenital heart defect, do not beat about the bush when your offspring asks questions. If a child suspects that something may be amiss, what with those visits to the hospital and those whispered consultations behind the screens, then your child's biggest enemy could be worry, and the best way of coping with it is to explain what is going on. Do not make the mistake of believing that having a heart defect somehow makes a child in any way insensitive or unintelligent. Relate the facts as you have understood them, or Perhaps ask the heart consultant to help you out, and explain the need (if need there be) for an operation. However, if things are not going well, it is important that you don't allow your anxiety to show; children are very sensitive to mood.
*15/353/5*
CARDIO & BLOOD

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