Analogues

Nitro ‑mic, Nitro, Nitroglycerin Health, Nitrogranulong, Nitromint, Nitrospray, Nitromax.

pharmachologic effect

It has an antianginal and antispasmodic effect, relaxes the smooth muscle cells of the walls of blood vessels, bronchi, digestive tract, biliary tract and ureters.

Indications for use

IHD – angina pectoris, including in the postinfarction period; for intravenous administration – an acute period of myocardial infarction, unstable and post-infarction angina pectoris, pulmonary edema, controlled arterial hypotension during surgical interventions to reduce bleeding in the surgical field, occlusion of the central retinal artery.

Dosage and administration

Inside, sublingually, in / in.

Capsule. To eliminate angina pectoris, they are taken sublingually (a tablet or capsule with p ‑rum is kept under the tongue until completely absorbed, without swallowing), immediately after the onset of pain – 0.5-1 mg per dose. If necessary, to achieve a faster effect, the capsule should be cracked immediately, the capsule can be repeated after 30–40 minutes.

Long-acting nitroglycerin, intended for the prevention of angina pectoris, is taken orally with water before meals. In mild cases – 0.0029-0.0058 g 2-3 times a day. In more severe cases – 0.0052-0.01 g 2-3 times a day. The maximum daily dose is 0.0348 g.

Solution. When using 1% ‑pra to stop an attack, 2-3 drops of pra are applied to a small piece of sugar and kept in the mouth without swallowing until completely absorbed. The duration of action after sublingual administration is about 45 minutes.

Aerosol for sublingual use . To stop an attack of angina pectoris – 0.4-0.8 mg by pressing the metering valve, preferably in a sitting position, while holding the breath at intervals of 30 seconds; then close your mouth for a few seconds.

If necessary, re-introduction, but not more than 1.2 mg, within 15 minutes. To prevent an attack – 0.4 mg 5-10 minutes before exercise.

Side effects

Dizziness, nitrate headache, tachycardia, skin flushing, feeling hot, lowering blood pressure; rarely – orthostatic collapse, cyanosis; feeling of dry mouth, nausea, vomiting, abdominal pain; rarely – anxiety, psychotic reactions, lethargy, disorientation; rarely – allergic reactions; local reactions with transdermal application: hyperemia and itching of the skin, burning, allergic contact dermatitis; blurred vision, general weakness, hypothermia, methemoglobinemia.

Contraindications

Hypersensitivity to nitroglycerin; for intravenous administration – hemorrhagic stroke, craniocerebral ‑injury, increased intracranial pressure, cardiac tamponade, constrictive pericarditis, hypovolemia. Use with caution in recent traumatic brain injury, acute myocardial infarction, glaucoma, severe anemia, hyperthyroidism, arterial hypotension with low systolic blood pressure, hypertrophic cardiomyopathy, severe renal failure, liver failure, during pregnancy and lactation, in children.

Overdose

Manifested by a decrease in blood pressure (< 90 mm Hg), orthostatic reactions, reflex tachycardia, headache, dizziness, drowsiness, feeling hot, nausea, vomiting, with a significant overdose (> 20 mg / kg) – collapse, cyanosis, methemoglobinemia, dyspnea and tachypnea.

With the development of overdose symptoms, further administration is stopped, the patch is removed. Lower the head end of the bed and raise the patient’s legs. As a rule, blood pressure returns to normal within 15-20 minutes after stopping the administration of nitroglycerin, then you can continue the introduction after the re-establishment of the infusion rate.