GLYCERYL TRINITRATE IS RAPIDLY ABSORBED INTRANASALLY

And the solution is easier and cheaper to praparethan the IV form To overcome the practical difficulties of giving glyeeryl lrinitrate (nitroglycerin) during anaesthesia. a non-sterile solution was prepared (by dissolving ten OAmg tablets in Smg normal saline) for intranasal administration. When pulmonary artery end­diastolic pressure increased by 5 torr or myocardial ischaemia was detected by ECG in 5 patients undergoing coronary artery bypass surgery, I ml of the solution was instilled intranasally. Glycery\ trinitrate was rapidly absorbed, with peak levels in central venous, arterial and peripheral venous blood 1-2 min later. The highest levels were measured in central venous blood and the lowest in peripheral venous blood; all feil rapidly and were barely detectable at 16 min. The half· life was 5.41-5.82 min; the clearance rates and apparent volume of distribution were high. Clinical efficacy was achieved within 2 min in aU patients, and without hypotension and tachycardia. Hence. this could well be a useful method of periodically administering glyceryl trinitrate. Hill . A.B. et al .: A~Q&Y S4: 346! Apr 1981)

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