From this article you will learn: what helps nitroglycerin. What is this medicine, under what pathologies and in what form is it prescribed. Who from doctors can recommend therapy. Contraindications to the use of the drug, its side effects.
content of the article:
- How does drug
- Nitroglycerin from
- angina, acute myocardial infarction
- from acute heart failure
- from chronic heart failure
- from other pathological conditions
- release and dosage forms
- When you can not use Nitroglycerin
- negative effects
Nitroglycerin medication - officiala medicinal product, a representative of a group of nitrates. The main mechanism of action is the relaxation of the walls of the vessels, the removal of their spasm. Depending on the form of application has a therapeutic effect within a few minutes, so the drug is actively used to provide emergency medical care.
| Cardiovascular diseases in which nitroglycerin is used | What clinical manifestations reduces or completely removes |
|---|---|
| Angina pectoris - pains in the heart against a spasm of blood vessels that carry blood to the myocardium | Painful syndrome |
| Acute myocardial infarction - formation in the heart muscle of a zone with an impaired blood flow(ischemia) | Pain Frequent pulse High blood pressure Fear of death |
| Pulmonary edema - severe left ventricular failure | Shortness of breath Wet chrochesBreathing types High pulse |
| Chronic myocardial insufficiency | Weakness Heaviness in the chest Shortness of breath Frequent contractions of the heart |
In an emergency situation, Nitroglycerin can be prescribed by any doctor, but the main specialists are therapists, cardiologists and anesthesiologists-resuscitators.
How the preparation works
Active active principle Nitroglycerin - Nitric Oxide. This chemical has an effect on the muscle cells of the vessels and relaxes them. The maximum effect develops in the walls of the veins, the arteries are less sensitive to the drug. It also acts on the capillary network, causing the valves of small vessels to relax.
| The therapeutic effect of the drug is composed of several elements | The result of such a complex effect |
|---|---|
| Reduction of venous blood flow to the right heart muscle | Unloading of the heart muscle by reducing the intensity of contraction |
| Decreased pressure in the right atrium and pulmonary artery | Decreased myocardial oxygen and nutrient demand |
| Normalization of vascular resistance in shallow vascular network | Improvement of blood flow in cardiac vessels |
| УменьшитьHeart failure with insufficient blood supply |
Click on photo to enlarge Nitroglycerin from angina
Angina pectoris or anginal pain is the main pathological condition in which nitroglycerin is used. The pain syndrome in the disease is associated with a spasm( a sharp narrowing) of the vessels feeding the myocardium. There is a zone with a violation of blood flow( ischemia), which manifests itself by pains behind the breastbone( angina pectoris, or angina pectoris).
| Action of Nitroglycerin | Symptoms that stop or decrease |
|---|---|
| Relaxation of the wall of myocardial vessels | Pain |
| Improvement of blood flow in the heart | Feeling of fear |
| Elimination of lack of oxygen and energy resources in the tissues of the heart muscle | Feeling of air shortage |
Impossibility to continue movement From acute myocardial infarction
Myocardial infarction is an acute shortage of blood flow in the heart muscle. The overwhelming majority is associated with atherosclerotic changes in the vascular wall of the arteries of the heart. When forming a foci with a disturbed blood supply in the tissues, a pain syndrome arises, which, in turn, activates the adrenal cortex and leads to the release of stress hormones( epinephrine, norepinephrine).These active substances cause vasodilation and acceleration of the heart( frequent pulse), which aggravates the severity of the pathology.
| Effects of Nitroglycerin | Symptoms that stop or decrease |
|---|---|
| Expansion of venous vessels in the body | Pain |
| Reduction in venous blood flow to the heart | Weight in the chest |
| Decrease in myocardial tension with contraction | Respiratory depression |
| Normalization pressure in the right chambers | Frequent heartbeat |
| Cardiacmuscles and vessels of the lungs | High blood pressure |
| Removal of spasm of the heart vessels | |
| Improvement of blood supply to the myocardium and lowering its blood flowbnosti |
in arterial blood of acute heart failure
This pathological condition is manifested by pulmonary edema on the backdrop of the ejection function of blood the left ventricle. There is a delay in contents in the vessels of the lungs, which leads to a violation of breathing and the lack of blood supply to all internal organs.
| Action Nitroglycerin | Symptoms that relieves or reduces |
|---|---|
| expansion peripheral vessels( mainly venous) | progressive dyspnea |
| Reducing fine vasculature resistance | Wet "gurgling" breathing |
| Improving infarction | Palpitation |
| Increase of stability of the heart muscle to the load | Heavinesschest |
| Reduction of pressure in the pulmonary artery | Reduction in the amount of urine |
| Reduction in the volume of incoming blood in the heart and lung | Disturbances of consciousness |
| High pressure |
From chronic heart failure
Chronic form of myocardial dysfunction is the outcome of many diseases of the cardiovascular system( hypertension and ischemic disease, congenital and acquired heart defects, vascular anomalies, atherosclerosis).Manifestations of a pathological condition are associated with insufficiency of the contractile function of the heart muscle and, as a consequence, a violation of blood flow in the large and small circles of the circulation.
Patients are troubled by weakness, reduced ability to perform even household stress, swelling, breathing and consciousness disorders, chest pain. The severity of symptoms depends on the degree of inadequacy of the heart and its individual chambers.
| Effects of Nitroglycerin | Symptoms that stop or reduce |
|---|---|
| Relaxation of veins of the extremities and abdominal cavity | Fatigue |
| Small spasm of small capillaries | Severity and chest pain |
| Decrease in pressure in the right chambers of the heart and pulmonary artery | High pressure |
| Improvement of blood flow in the myocardium | Highpulse |
| Increased endurance of the heart muscle in conditions of increased stress | Difficulty in breathing |
| Darkening in eyes |
Other pathological conditions
Nitroglycerin is traditionally associated with the treatment of heart disease, but the features of the medicinal product allows its use in other clinical situations.
| Pathological condition | Nitroglycerin |
|---|---|
| Disturbance of bile flow( concrements, inflammation of the bile ducts, spasm of ducts) | Relaxation of the bile duct walls Restoration of bile passage Reduction of the pain Normalization of digestion and liver function |
| Bronchostenitis( asthma, inflammatory changes) | Extensionlumen of the bronchial tree Stimulation of the secretion of the secret Restoration of the respiration |
| Spastic changes in the gastro-(colitis, irritable bowel syndrome) | Bowel wall relaxation Intestinal passage passage normalization Elimination of pain and stool dislocation |
| Ureteral spasm( concrements, innervation, inflammation) | Ureteral expansion Urine flow normalization Pain relief |
| Uterine contractionpainful menstruation, inflammation) | Elimination of increased contractility of the uterus Reduction of the pain syndrome |
| Spasm of cerebral vessels( vegeVascular Dystonia, Trauma, Tumors) | Vascular Extension Improvement of Blood Flow in the Brain Elimination of the Headache |
Click on photo to enlarge Release and Dosage Forms
| By Time of Onset and Duration of Action | Form | Single dose | Daily Dose |
|---|---|---|---|
| Short, for ingestion or under tongue | Solution in alcohol | 4 drops | 16 drops |
| Solution in oil | |||
| Tablets | 1,5 | 6 | |
| Short, for intravenous use | Solution one for injection | 1 mL 0.01% solution per minute | Individually |
| Alcohol solution | |||
| Long-acting( extended-release) for oral and topical application | Tablets | 1-4 | 6 |
| plates 1-6 | 12 | ||
| Capsules | 1-2 | 6 | |
| Ointment | 0.5-5 cm | Individually | |
| Plaster | 1 | Individually |
Rapid action drugs are used in acute and emergency situations. The effect occurs after 2-5 minutes, lasts up to 20-30 minutes. Prolonged dosage forms are prescribed in treatment regimens for chronic heart failure and paroxysmal angina pectoris. The action develops gradually and lasts from 6 or more hours depending on the specific preparation.
With the continuous use of Nitroglycerin, drug resistance develops, therefore, a drug change for another nitrate and periodic cancellation of treatment for up to 1 day are required.
When Nitroglycerin
can not be used The use of the drug in some cases has a negative effect, and can even lead to death. Pathological conditions in which Nitroglycerin is contraindicated:
- Individual intolerance.
- Significant decrease in blood pressure( upper <100 mm Hg, lower <60 mm Hg) in case of shock conditions, collapse, acute myocardial infarction.
- Cardiomyopathy with a significant thickening of the heart muscle.
- Inflammation of the heart bag, accompanied by proliferation of connective tissue elements in it and gluing of the pericardial cavity.
- Pulmonary edema of toxic origin( poisoning).
- Closed-angle glaucoma with high pressure inside the eye.
- Cardiac tamponade.
- Increased pressure inside the skull of any genesis( bleeding in the brain structures, trauma, swelling).
Conditions and situations in which the therapeutic effect should be higher than the risk of complications( in these cases the decision of the appointment is made by the attending physician, based on the specific case of the disease):
- any gestation period;
- breast-feeding;
- disturbed blood flow in the brain;
- senile age( more than 80 years);
- marked atherosclerotic changes in cerebral vessels;
- hemoglobin level below 60 g / l( severe anemia);
- failure of kidney and liver function;
- alcohol intoxication.
negative effects from the drug
| bodies or kind of reaction | Manifestations |
|---|---|
| Heart and vessels | Headache Dizziness Redness of the skin Feeling the heat Low pressure rapid pulse collapse |
| Gastrointestinal | Vomiting Nausea |
| Brain | Anxiety Psychosis |
| Allergic reactions | Cutaneous itching Rash |
| Reactions at the injection site | Red Moderate itching and burning |
| Other | The appearance is inactiveth forms of hemoglobin( methemoglobinemia) |
