Nitrokörper

  • W. Schneider
  • M. Kaltenbach
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 9 / 3)

Zusammenfassung

Die Nitrate fanden im 19. Jahrhundert Eingang in die Therapie. Die ersten Substanzen, die medizinisches Interesse erlangten, waren Glyceryltrinitrat (Nitroglycerin), welches von Sobrero synthetisiert wurde und Amylnitrit, dessen Darstellung durch Balard erfolgt war (Sobrero 1847; Balard 1844). Beide Substanzen wurden zunächst bei einer Vielzahl von Erkrankungen eingesetzt, bis die günstige Beeinflussung des Angina pectoris-Schmerzes durch Amylnitrit durch Brunton und durch Glyceryltrinitrat durch Murrell beschrieben wurde (Brunton 1857; Murrell 1879). Glyceryltrinitrat wurde wegen seiner längeren Wirkung in den folgenden Jahren dem Amylnitrit vorgezogen und hat bis in die Gegenwart seine wichtige Bedeutung in der Therapie der Angina pectoris beibehalten. Die Einführung der sogenannten Langzeitnitrate, wie sie in erster Linie durch die Nitratester von Isosorbid, Erythrit, Pentaerythrit und Mannit repräsentiert werden, geht auf Untersuchungen von Krantz et al. (1940) zurück. Ihre Einführung erweiterte die Anwendungsmöglichkeiten der Nitrate auf die prophylaktische Therapie der Angina pectoris, während bis dahin nur eine Kupierung des Anfalles üblich war. Nach anfänglicher Ablehnung fanden die oralen Darreichungsformen bald einen festen Platz in der Behandlung der Angina pectoris und stellen heute einen wichtigen Bestandteil der medikamentösen Therapie dar. Die Indikation der Nitratbehandlung wurde in den letzten Jahren auf die Herzinsuffizienz und das kardiale Lungenödem erweitert (Bussmann et al. 1975 a; Cohn et al. 1977; Bussmann u. Schupp 1977).

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  • W. Schneider
  • M. Kaltenbach

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