Section Links

Nitroglycerin

vasodilator

uses
mechanism
dose and half-life
adverse drug reactions
counter-indications and drug interactions
metabolism and excretion
dependency

Uses

appears to releive symptoms, not reduce events.

angina
- improves exercise tolerance, time to onset of ST depression; can also be used in combination with neta-blockers and calcium channel blockers
myocardial infarction
acute congestive heart failure

Mechanism

nitric oxide relaxes smooth muscle, leading to vasodilation, especially in veins
- increased venous pooling leads to decreased preload and wall stress
at higher doses, lowered BP can desult in tachycardia
dilates coronary arteries

Dose and Half Life

sublingual tabs or spray

used for attacks of angina, or prophylactically
short acting; onset 1-5 minutes, duration 15-30 mins
use this first in emergencies

oral administration leads to liver metabolism
IV in emergencies
transdermal patch provides 8-12 hours of activity

Adverse Drug Reactions

short term

headaches
reflex increase in heart rate due to baroreceptor response (tachyphylaxis)
high degree of tolerance over time

long term

Counter-Indications and Drug Interactions

can cause profound hypotension if used with sidenafil (Viagra)

Metabolism and Excretion

Dependency