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PubMed · 406802

Impotence responsive to glyceryl trinitrate.

J W Mudd
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Abstract

The author presents suggestive evidence that glyceryl trinitrate served to treat and diagnose atherosclerotic impotence in a man with psychogenic impotence. The prevalence of atherosclerotic impotence is not known but may be relatively high in older men. Vasodilators may be effective in diagnosing these patients, who do not have clear signs of arterial insufficiency of the lower extremities (e.g., Leriche's syndrome). The author postulates a pharmacological interaction between organic nitrates and imipramine.

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Angina PectorisArteriosclerosisDepressionErectile DysfunctionHumansImipramineMaleMiddle AgedNitroglycerinPentaerythritol TetranitrateCase ReportsJournal Article

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BibTeXRIS

J W Mudd. 1977. Impotence responsive to glyceryl trinitrate.. https://doi.org/10.1176/ajp.134.8.922

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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