Nitroglycerine

It is a volatile liquid which is absorbed on the inert matrix of tablet and rendered non explosive. The sublingual route is used when terminating an attack or aborting an imminent one. Nitroglycerine is readily absorbed from skin & a cutaneous application has effect for 4-6 hous. I.V. route provides rapid, steady titratable plasma concentration for as long as desired. Nitroglycerin is a medication belonging to the class of nitrates, primarily used for the treatment of angina pectoris (chest pain) and congestive heart failure. It works by dilating blood vessels, improving blood flow, and reducing the workload on the heart.

Indications

Unstable angina, coronary vasospasm, LVF accompanying MI, hypertension during cardiac surgery.

Dosage

-The dosage of nitroglycerin varies depending on the form of the medication (tablets, patches, ointment, or spray) and the specific condition being treated. It is crucial to follow the prescribed dosage and administration instructions provided by a healthcare professional. -Acute attack. 0.5 mg every 3 minutes till cessation of pain or limiting side effects appear. Prophylaxis : 0.5 mg prior to activity. To be chewed & not swallowed.

Contra-Indications

-Nitroglycerin is contraindicated in individuals with: Known hypersensitivity to nitrates or nitroglycerin. Severe anemia. Increased intracranial pressure. Circulatory shock. -Cerebral haemorrhage, head trauma, hypertrophic cardiomyopathy.

Special Precautions

-Inform your healthcare provider about any existing medical conditions, especially hypotension, recent heart attack, or head trauma. Avoid sudden discontinuation of nitroglycerin, as this can lead to rebound angina. -Caution is advised when using nitroglycerin in elderly patients and those with impaired liver or kidney function. -Cerebrovascular disease, lung disease. Paediatrics: Not usually prescribed. Pregnancy: Safety not established. Lactation: Caution.

Side Effects

-Common side effects may include headaches, dizziness, flushing, and low blood pressure. Severe allergic reactions are rare but possible. Seek medical attention if you experience chest pain or a sudden decrease in blood pressure. -Throbbing headache, flushing, weakness, sweating, palpitation, dizziness & fainting. Tachycardia. Methaemoglobinaemia.

Drug Interactions

-Concomitant use with phosphodiesterase inhibitors (e.g., sildenafil) may lead to severe hypotension. -Beta-blockers, calcium channel blockers, and other vasodilators can potentiate the hypotensive effects of nitroglycerin. -Alcohol may enhance the hypotensive effects of nitroglycerin. -Orthostatic hypotension may be produced by combined use of Calcium channel blockers, antihypertensives,phenothiazines & tricyclic antidepressants. Alcohol may cause severe hypotension & collapse.