Nitroglycerin: what helps, who is indicated and contraindicated, its effect on the heart

Nitroglycerine - one of the most famous and common drugs that quickly relieve attacks of ischemia and angina pectoris. It belongs to the group of antianginal and vasodilating agents. For those who are interested in the drug Nitroglycerin, which helps, it can be said more simply - the drug reduces the heart's need for oxygen and has a vasodilating effect.

The composition of the tablets includes the main substance - nitroglycerin (with glucose) 0.5 mg, as well as auxiliary elements - colloidal silicon dioxide, potato starch, calcium stearate, microcrystalline cellulose, lactose monohydrate.

Many people know about Nitroglycerin, which helps the drug, but not everyone knows that it is a chemical explosive compound. However, you should not be afraid - in medicinal products, its concentration is very low.

With standard sublingual application under the tongue, its action begins after 30-120 seconds after taking the pill and continues 30-45 minutes.

The active substance is instantly absorbed from the surface of the mucous membranes and enters the bloodstream.

Bioavailability (the ability of the drug to be absorbed in the body) dose of 0.5 mg - 100%. In this case, the greatest accumulation in the blood occurs within 5 minutes.

The agent is excreted from the body through the kidneys. It is able to accumulate in the walls of blood vessels and bind tightly to erythrocytes.

Older people are most often interested in the following information about the drug Nitroglycerin - what helps, how often Nitroglycerin can be taken, the mechanism of action. The last factor includes several components.

The tool increases the lumen of arterial and venous vessels in the large and small circles of blood circulation. This reduces the pressure in the veins and the flow of venous blood to the heart. This reduces high blood pressure, which relieves stress on the heart.

In addition, the drug eliminates and precedes the nerve contraction of the coronary vessels. It promotes their expansion, which normalizes blood circulation in the ischemic area of ​​the main heart muscle - the myocardium.

Nitroglycerin comes in different forms:

• pills;
• spray;
• ampoules;
• alcohol solution;
• films on the gums.

They all have different methods and speed of impact on the body.

Nitroglycerin (tablets): dosage and instructions for use of the drug

The main indication for taking a peripheral vasodilator is angina pectoris, both for short-term prophylaxis and for blocking the attacks of the disease.

Nitroglycerin (tablets) is necessary for myocardial infarction during exacerbation of the condition and during rehabilitation treatment. In addition, the drug is used for acute left ventricular failure.

The drug treatment regimen, the required dose and dosage form should be established by the doctor on the basis of individual indications, depending on the clinical picture.

The usual dose of medication for angina pectoris is 1 tablet (0.5 mg) sublingually (under the tongue) or buccal (on the cheek). For some patients, even a smaller amount is enough - half or even a third of the pills may become their norm.

In most cases, the effect occurs through 1-2, maximum - 5 minutes. If the pain disappeared before the Nitroglycerin tablet had time to dissolve, then its remainder can be removed from the mouth. In the opposite cases - if after 5-6 minutes the pain is not stopped, - another dose should be taken. If you need a quick effect, the tablet can be chewed. When this does not help, you need to urgently call doctors - there is a high probability of myocardial infarction.

With repeated administration of Nitroglycerin, the dosage may be increased to 2-3, and sometimes even before 5-6 tablets. This is due to the habituation of the body to the drug.

Capsules should be taken while sitting. If you find pain while walking, it recommends finding a suitable place and sitting down.

It is allowed to use Nitroglycerin as a preventive medicine. In this case, the pill should be taken before the onset of a stressful situation for the body, which may be associated with any emotional or physical overload.

Often in the pharmacy, instead of Nitroglycerin (tablets), they offer to purchase a spray. It is very simple to use the product - in a sitting position, they introduce 1-2 doses under the tongue or on it by pressing a special valve. Then they remain with their mouth closed for a few seconds, without swallowing. If necessary, the procedure can be repeated - a maximum of 3 times in 15 minutes.

In order to prevent 1 dose is administered per 7-10 minutes before planned stress or stress.

Do not shake the vial of Nitroglycerin with the drug before use.

One press of the dispenser delivers 0.4 mg of nitroglycerin. Inhalation of the spray is contraindicated.

In case of emergency: 1-2 tablets under the tongue every 15 minutes, in the absence of the expected effect, ampoules with the medicine are used. Their dosage can be different - 2, 5 and 10 ml. There are also injection vials of 50, 10 and 500 ml.

There are 2 types of films for gluing on the gums:

• pale yellow with a dosage of 1 mg;
• green - 2 mg.

The doctor should initially determine the required dose. After that, the patient can independently take the drug. At the first attacks of pain, the film should be glued to the upper gum in the canine area, pressing it with your fingers for a few seconds.

Then the substance is left alone until it is completely dissolved. For the best effect, you can several times (enough 2-3) licking the film - this will accelerate the flow of nitroglycerin into the blood.

If the pain disappears quickly, the remainder of the substance can be removed. If the expected action is absent, then another film is glued. When this does not help, it is necessary to urgently seek medical help.

Medication Nitroglycerin - its effect on the heart and possible side effects

Thanks to the release of the active substance nitric oxide, smooth muscles are relaxed.

Under the influence of glyceryl trinitrate, which is one of the active elements of nitroglycerin, expand lumens of large and small blood vessels, and arterioles are less susceptible to this than significant arteries and veins. Because of this, the medication Nitroglycerin reduces peripheral stress and blood pressure.

At the same time, the meningeal vessels expand, which can cause spasm and, as a result, headache.

When using the drug, a special mechanism of action is activated, which consists in the fact that under the influence nitric oxide inside the cells, a protection is formed against calcium ions, which tend to get into the smooth muscle the cloth.

The action of Nitroglycerin on the heart is such that smooth muscle cells come to a relaxed state, and the lumens of blood vessels expand. This reduces venous return to the heart (reduced preload) and systemic resistance (less afterload). All this reduces the need for oxygen in the myocardium.

In addition, the effect of Nitroglycerin on the heart involves dilatation (expansion) of the coronary vessels, blood flow is activated in them, then reassigning to areas with reduced blood flow. This speeds up the flow of oxygen to the myocardium.

According to the instructions for use, there are contraindications for taking Nitroglycerin:

• individual intolerance to the components of the drug;
• hemorrhagic stroke;
• acute vascular insufficiency (collapse);
• anemia;
• mitral or aortic stenosis;
• cerebral hemorrhage;
• toxic pulmonary edema;
• shock;
• blood pressure with indicators less than 90/60 - hypotension;
• high blood pressure, including as a consequence of a head injury;
• a decrease in the volume of circulating blood - hypovolemia;
• angle-closure glaucoma with increased intraocular pressure (in this case, it can also be prescribed Simbrinza);
• renal or hepatic impairment.

As a result of taking the medicine Nitroglycerin, side effects may occur:

1. Digestive system: vomiting and nausea.
2. CNS (central nervous system): motor restlessness, complete breakdown, dizziness, blurred vision, headache (it is especially severe at the beginning of therapy, over time decreases).
3. Allergic reactions: itching, skin rash, skin redness and burning.
4. Cardiovascular system: increased blood flow to the skin - hyperemia, fever, tachycardia, arterial hypotension.
5. Hematopoiesis: cyanosis (cyanosis), methemoglobinemia.

Rarely, most often with an overdose, vascular collapse is noted. Also in such cases, a severe headache, a sharp decrease in blood pressure, dizziness, tachycardia (heart palpitations), vomiting, diarrhea, weakness, flushing or fever, drowsiness.

Taking a significant dose of the drug Nitroglycerin (over 20 mg - 40 or more tablets at the same time) can lead to increased breathing (tachypnea), shortness of breath (dyspnoea), cyanosis, methemoglobinemia, orthostatic collapse, and in the most severe cases, fatal the outcome.

In case of an overdose, the patient should be laid down by raising his legs, and then call an ambulance.

Nitroglycerin analogs include:

• Anhibid;
• Angiolingual;
• Myoglycerin;
• Nitragin;
• Nitroglycerol;
• Nitrognaranulong;
• Nitrocardiol;
• Nitrong Forte;
• Trinitrol.

The price of a drug can vary significantly depending on the region, manufacturer and form of release. The cost of antianginal tablets ranges from 13 to 55 rubles, spray - from 75 to 117 rubles. The most expensive is nitroglycerin concentrate - from 440 to 680 rubles.

Feedback on application

Galina Vladimirovna

“Now there are a lot of different drugs. But with my angina pectoris, the old-fashioned way I prefer Nitroglycerin, and in tablets. My daughter bought it in a spray can, but I didn't like it. And so I put a pill under my tongue - the pain goes away immediately. But I rarely use this medicine - for every day it is better to use Validol or Corvalol as a sedative. And the effect of Nitroglycerin on the heart is too strong to be used constantly. "

Sergei

“I was diagnosed with a heart disease - IHD, and prescribed nitroglycerin. And he did not suit me at all - it makes me sick and my head breaks. Although it is cheap, I had to stop taking it. "

Elizabeth

“I remember nitroglycerin for a long time, even my grandmother took it. I somehow didn't need him, my health seems to be all right. But recently at work I was worried with a report, and at one point I suddenly had a sharp pain in my chest, so much so that I could not breathe calmly. A colleague saw - she immediately took out some kind of pill and told me to put it under my tongue and sit quietly.
I did just that, and after a minute the pain began to become less and less, and then it completely disappeared. True, it happened once, but since then I have always carried these pills in my purse - just in case. And, by the way, I change them periodically - it is not recommended to store them for a long time, they may lose all their properties ”.