Description
Nitroglycerin Pharmacodynamics
Peripheral vasodilator with predominant effect on the venous vessels. The action of nitroglycerin is mainly related to reduction of myocardial oxygen demand by reducing preload (dilation of peripheral veins and reduction of blood flow to the right atrium) and postload (reduction of total peripheral vascular resistance).
It has a central inhibitory effect on the sympathetic vascular tone, inhibits the vascular component of pain syndrome formation. Causes meningeal vasodilation, which explains the headache when using it.
When using sublingual forms, an angina attack usually stops after 1.5 min, hemodynamic and antianginal effect lasts from 30 to 60 min.
Indications
Constipation and short-term prophylaxis of angina attacks
Contraindications
Hypersensitivity to nitrates, shock, collapse, simultaneous use of FDE 5 inhibitors (sildenafil, tadalafil, vardenafil, etc.), age under 18 years (effectiveness and safety has not been established for age under 18 years).
With caution (comparing risk and benefit): craniocerebral hypertension, cardiac tamponade, uncontrolled hypovolemia, in patients with heart failure with normal or low pulmonary artery pressure, arterial hypotension (systolic blood pressure less than 90 mm PT. ), closed-angle glaucoma with high intraocular pressure, severe anemia, hyperthyroidism, toxic pulmonary edema, subarachnoid hemorrhage, recent head trauma, hemorrhagic stroke, conditions accompanied by decreased left ventricular filling pressure (acute myocardial infarction, isolated mitral stenosis, constrictive pericarditis), idiopathic hypertrophic subaortic stenosis, cerebral circulatory disorders, severe renal and/or hepatic insufficiency and methemoglobinemia).
Administration during pregnancy and lactation is possible only if there are vital indications.
Directions for use and dosages
- Nitroglycerin is recommended for use as prescribed by the doctor.
- Nitroglycerin should be taken immediately at the first signs of an attack of angina:
1 tablet of Nitroglycerin is placed under the tongue and held until completely dissolved, without swallowing. The usual dose of the drug is 1 tablet under the tongue. - If the angina attack is not stopped within 5 minutes, you must take 1 more tablet of Nitroglycerin.
- If there is no therapeutic effect after taking 2 tablets, it is necessary to call a doctor.
- With frequent attacks of angina it is advisable to use prolonged nitroglycerin drugs.
