Learn about the cardiovascular drug Nitroglycerin

The article was professionally consulted with Doctor Cardiologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Nitroglycerin is commonly used in a number of cardiovascular conditions. So what is Nitroglycerin drug, how to use this medicine? Please read the following article.

Nitroglycerin is a vasodilator, prepared in many different dosage forms and strengths, including:
Sublingual tablets with strengths: 0.3 mg, 0.4 mg, 0.6 mg. Long-acting tablets with strengths: 1 mg, 2 mg, 3 mg, 5 mg. Long-acting capsules with strengths: 2.5 mg, 6.5 mg, 9.0 mg. Aerosol metered dose (into the tongue) with the content: 200 doses/bottle, 0.4 mg/spray dose. Ointment for topical application with a concentration of 2%. Patches with strengths: 0.1 mg/hour, 0.2 mg/hour, 0.3 mg/hour, 0.4 mg/hour, 0.6 mg/hour and 0.8 mg/hour. Solution for IV injection with concentrations: 0.5 mg/ml x 5 ml, 1 mg/ml x 10ml, 5 mg/ml x 5 ml and 10 ml. Once inside the body, nitroglycerin is converted to nitric oxide (NO). NO causes vasodilation, allowing blood to flow more easily. This will help relieve symptoms of angina caused by ischemic heart disease, coronary artery disease. In addition, the drug Nitroglycerin also works to dilate the arteries and veins to help lower blood pressure, reduce the burden on the heart, especially beneficial for people with heart failure.
Nitroglycerin is indicated in the following cases:
Prevention and treatment of angina; Treatment of congestive heart failure; Acute myocardial infarction ; Paroxysmal intraoperative hypertension. Nitroglycerin is contraindicated in the following cases:
Low blood pressure; Cardiovascular collapse; Severe anemia; Increased intracranial pressure due to head trauma or cerebral hemorrhage; Right ventricular myocardial infarction; Aortic valve stenosis ; Obstructive hypertrophic cardiomyopathy; Constrictive pericarditis; Allergy to organic nitrates; Closed angle glaucoma; Concomitant use with phosphodiesterase-5 (PDE-5) inhibitors such as Sildenafil, Tadalafil, Vardenafil.

The dosage and form of Nitroglycerin used should be according to the prescription of a specialist. The recommended dose of Nitroglycerin in specific cases is as follows:
Treatment of angina pectoris: Use a sublingual drug with a dose of one 0.5mg Nitroglycerin tablet (usually 0.3 to 0.6 mg). , take 1 pill every 5 minutes until the pain is gone, no more than 3 times in 15 minutes, if it doesn't feel better, go to the doctor immediately. It is possible to use aerosol spray tongue, 0.4 mg each time, spray 1-2 times under the tongue, then close the mouth, do not inhale. If the pain does not go away for more than 20 minutes, you should immediately contact a doctor. During the day can be used many times if the pain recurs and you do not have headaches, low blood pressure. Prevention of angina: Use slow-release capsules 2.5 - 6.5mg, taken 3-4 times/day. You can also use a patch on the skin of the left breast with a dose of 5-10 mg or apply 2% ointment on the skin of the chest, thighs or back, the dose prescribed by a specialist. Treatment of congestive heart failure in combination with other drugs: In acute pulmonary edema, nitroglycerin should be used in the form of sublingual tablets or sprays for rapid action. In case of chronic heart failure, the slow release form should be used 2.5 - 6.5 mg, 3-4 times / day. Treatment of acute myocardial infarction: Use intravenous nitroglycerin within the first 24 - 48 hours with a starting dose of 12.5 - 25 micrograms / minute, maintenance dose 10 - 20 micrograms / minute. Note that systolic blood pressure < 90 mmHg and heart rate > 110 beats/min should not be allowed. Treatment of hypertension: Use intravenous drugs at a dose of 5-100 micrograms/minute. When the patient responds, reduce the dose and increase the interval between infusions. An overdose of the cardiovascular drug Nitroglycerin can cause severe hypotension with cardiovascular collapse, syncope, dizziness, severe headache, visual disturbances, increased intracranial pressure, abdominal cramps, nausea and vomiting, diarrhea, dyspnea, methemoglobinemia, paralysis, coma.
How to handle an overdose of Nitroglycerin: Put the patient in a lying position, raise the legs, with the aim of improving the amount of blood returning from the veins. Administer fluids and keep the airway open. Vasopressors should not be used because they do more harm than good.
When methemoglobinemia occurs, it is necessary to treat with injection of methylene blue solution.
Early gastric lavage must be performed if the drug is to be administered via the gastrointestinal tract. If taking a large amount of medicine, activated charcoal can be used within 1 hour.
If you forget to take a dose of Nitroglycerin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time.

Common side effects of Nitroglycerin include:
Headache; Dizzy; heart palpitations ; Lower blood pressure; Flushed; Allergic dermatitis. Less common side effects of Nitroglycerin include:
Nausea; Allergy ; Rashes; Rare side effects of Nitroglycerin include:
Syncope; Cyanosis, methemoglobinemia; Loss of taste. Side effects of undetermined frequency of Nitroglycerin include:
Glaucoma; Hypoxemia; Nervous. => Advice from Doctor Cardiologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital: Nitroglycerin is a vasodilator drug, prepared in many forms. different dosage forms and dosages. Users need to learn to know the effects of the drug.
Above are the uses, doses and notes when using the cardiovascular drug Nitroglycerin. To ensure the safety of your health and maximize the effectiveness of treatment, you need to take the medicine exactly as directed by your doctor.