The role of nitroglycerin preparations in the treatment of post-acute and chronic pancreatitis.

The role of nitrate compounds in the therapy of pancreatic diseases is discussed in this review. A short overview is given about the physiological background of the treatment: the regulation of Oddi's sphincter function and its pharmacology. An adjuvant role is attributed to the free outflow of pancreatic secretion in the treatment of pancreatic pain and in the prevention of relapses. The authors describe their clinical practice during the last 15 years: nitrates with short half-life in the treatment of acute pancreatitis (amylnitrit or nitroglycerin spray) which have a low risk of developing nitrate tolerance; chronic administration of retard nitroglycerin in chronic pancreatitis and Oddi's sphincter hypertonic dyskinesia. For preventing the induction of nitrate tolerance, Nitromint retard is recommended twice a day combined with a calcium antagonist or with theophylline during the nitrate-free period.