Mononitrates

The nitrates have remarkable clinical effects that have stood the test of time in the management of ischemic heart disease. What is unusual about this class of com pounds is that, after many years of clinical use, we are still exploring new avenues as to the vascular mechanisms of their effect, their applications in treating other clini cal conditions, and the development of products with more favorable pharmacoki netic properties. This volume represents the proceedings of a symposium held June 14-16, 1984, in Montreux. The papers were selected to explore the current state of knowledge re garding the mechanisms of action, pharmacokinetics, and clinical efficacy of ni trates. Particular attention has been given to newer studies utilizing the 5-mononi trate metabolite of isosorbide dinitrate, a drug whose pharmacokinetic properties may make it an important new agent in the treatment of angina and congestive heart failure. One of the benefits of an international meeting of experts sharing their views on an internationally used group of drugs is that differences in concepts and clinical practice become apparent and can be discussed. The Montreux forum made it clear that clinicians in North and South America and Europe have diverging views on how the nitrates should be used.