Isosorbide dinitrate (ISDN) is a medication used for heart failure, esophageal spasms, and to treat and prevent chest pain from not enough blood flow to the heart. It has been found to be particularly useful in heart failure due to systolic dysfunction together with hydralazine. It is taken by mouth or under the tongue.Common side effects include headache, lightheadedness with standing, and blurred vision. Severe side effects include low blood pressure. It is unclear if use in pregnancy is safe for the baby. It should not be used together with medications within the sildenafil family. ISDN is in the nitrate family of medications and works by dilating blood vessels.Isosorbide dinitrate was first written about in 1939. It is on the World Health Organizations List of Essential Medicines. ISDN is available as a generic medication. A long-acting form exists. Medical uses
It is used for angina, in addition to other medications for congestive heart failure, and for esophageal spasms. It is available as an oral tablet both in extended release and slow release. The onset of action for Isosorbide Dinitrate is thirty minutes and the onset of action for oral extended release is 12–24 hours. Long-acting nitrates can be more useful as they are generally more effective and stable in the short term. Side effects
After long-term use for treating chronic conditions, tolerance may develop in patients, reducing its effectiveness. The mechanisms of nitrate tolerance have been thoroughly investigated in the last 30 years and several hypotheses have been proposed.
This rising is said to have been started by a peasant who saw a vision. The movement became known as the laudesi from their constant hymn singing. At its peak, a group of over 15,000 adherents gathered in Modena and marched to Rome, but the movement rapidly faded when one of its leaders was burned at the stake by order of Boniface IX. In Germany
The German and Low Countries movement, the Brothers of the Cross, is particularly well documented - they wore white robes and marched across Germany in 33.5 day campaigns (each day referred to a year of Jesuss earthly life) of penance, only stopping in any one place for no more than a day. They established their camps in fields near towns and held their rituals twice a day. The ritual began with the reading of a letter, claimed to have been delivered by an angel and justifying the Flagellants activities. Next, the followers would fall to their knees and scourge themselves, gesturing with their free hands to indicate their sin and striking themselves rhythmically to songs, known as Geisslerlieder, until blood flowed. Sometimes the blood was soaked up in rags and treated as a holy relic. Originally members were required to receive permission to join from their spouses and to prove that they could pay for their food. However, some towns began to notice that sometimes Flagellants brought plague to towns where it had not yet surfaced. Therefore, later they were denied entry. They responded with increased physical penance.