Cardiovascular Journal of Africa: Vol 32 No 3 (MAY/JUNE 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 3, May/June 2021

174

AFRICA

Trust the

Original

S3 ISMO-20 R/7.1.4/136. Isosorbide-5-mononitrate 20 mg/tablet.

For full prescribing information, please refer to package insert.

Pharmaco Distribution (Pty) Ltd. 3 Sandown Valley Crescent, South Tower, 1st Floor, Sandton, 2196; PO Box 786522, Sandton, 2146, South Africa. Tel: + 27 11 784 0077.

Website:

www.pharmaco.co.za

Long-term prophylaxis and management of

Angina Pectoris

2,3

100%

bioavailability

No first-pass metabolism

Twice daily

dosage regimen shown

to avoid withdrawal and tolerance

References: 1.

South African approved ISMO package insert.

Ismo 20 Product Monograph (2015).

Abshagen, U., 1992. Pharmacokinetics of isosorbide mononitrate.

The American Journal of Cardiology,

[online] 70(17), pp.G61-G66.

Thadani U, Maranda CR, Amsterdam E, et al. Lack of Pharmacological Tolerance and Rebound

Angina Pectoris during Twice-daily Therapy with Isosorbide-5-Mononitrate.

Annals of Internal Medicine.

1994; 120:353-359. IS_0120.

the world.

This case of pheochromocytoma rupture-induced

basal TTS is the first explicit report in the literature.

Conclusion

This case provides us with three insights: (1) young patients with

abdominal pain and clinical evidence of ACS should be checked

for pheochromocytoma; (2) the impaired LV systolic function

recovered in two to three weeks with timely mechanically assisted

therapy; (3) TTS did not re-occur even without taking any beta-

blockers or ACEIs after the tumour was removed.

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