PAIN SCORING - A METHOD FOR ASSESSING ACUTE ANTIANGINAL THERAPY COMPARISON OF THE RESPONSE TO ACUTE SUBLINGUAL ADMINISTRATION OF AN ISOSORBIDE DINITRATE TABLET, ISOSORBIDE DINITRATE SPRAY AND NITROGLYCERIN SPRAY IN UNSTABLE ANGINA

It is difficult to assess acute therapeutic intervention therapy, part icularly in patients with unstable angina. Our aim was to evaluate the feasibility of a pain-scoring method and to compare the response to s ublingual administration of an isosorbide dinitrate (ISDN) tablet, ISD N spray or nitroglycerin (NTG) spray. Pain scoring was assessed by the subjective grading of the patients' pain severity from 1 to 10. We st udied 205 patients (mean age 66 +/- 13 years). Pain attenuation, defin ed as at least 50% reduction in pain intensity, occurred in the ISDN t ablet, ISDN spray and NTG spray groups after 360 +/- 290, 318 +/- 289 and 233 +/- 271 s, respectively (p = 0.0005). In conclusion, pain scor ing is a feasible and useful clinical method to assess antianginal the rapy in unstable angina patients. Sublingual nitrate sprays, particula rly NTG, seem to alleviate anginal pain faster than ISDN tablets in th is patient population.