Tunpy Diary

Nitroglycerin – Composition, Uses and Side Effects

Introduction

When something restricts blood flow to the heart muscle, a person may experience intense chest pain that doctors call angina. People can use the drug nitroglycerin to relieve this pain.

Most often, the reason for this decrease in blood flow is plaque formation and the narrowing of the arteries supplying blood to the heart.

People can also use nitroglycerin to treat anal fissures as it opens up the blood vessels.

This article is all about the composition of nitroglycerin, the diseases it is used to treat, its recommended dosage, some side effects and a few frequently asked questions, so let’s get started.

Composition

Nitroglycerin is available in various forms, you can find nitroglycerin in tablets and aerosols form and also in ointments and patches form. This describes why it is the most commonly prescribed drug used to treat heart conditions.

Mode of Action

A patient with Angina pectoris (chest pain or discomfort due to reduced blood flow to the heart) or congestive heart failure can take nitroglycerin. When nitroglycerin is administered to such a patient, the blood vessels and smooth muscle cells release a chemical called Nitric oxide which is a vasodilator. It dilates the blood vessels which means more blood can flow through the vessels. This vasodilating effect is markedly increased in veins. This venous dilation decreases the quantity of blood returning to the heart, thereby reducing the heart’s workload and oxygen requirements. Other than the veins, the coronary arteries also get dilated which increases the blood flow to the heart.

Uses

Angina Pectoris

Nitroglycerin is used to treat certain heart conditions. Angina pectoris is one of them. Angina pectoris is associated with chest pain or discomfort. This discomfort in the chest region is caused by the decreased blood flow to the heart muscle. Various diseases can decrease or obstruct the blood flow to the heart, atherosclerosis is one of them. Atherosclerosis causes the narrowing of the coronary artery which supplies the blood to the heart because of the formation of plaques in the vessels which obstruct the lumen of the vessels.

When the blood vessels get delayed, the flow of the blood to the heart increases or in other words gets improved, which decreases the frequency and severity of chest pain episodes. It can be administered sublingually as tablets or mists for immediate relief, or as long-acting formulations for prevention.

Congestive Heart Failure

The heart of a person with congestive heart failure is not able to pump blood effectively to every cell of the body. This compromised blood flow to body tissues can result in the death of such tissues. Nitroglycerin is used in such cases to reduce or improve the symptoms of heart failure which include shortness of breath and fluid retention (edema).

The main site of action of nitroglycerin is the veins. By dilating the veins, nitroglycerin decreases the volume of blood returning to the heart, thereby reducing the strain on the weakened cardiac muscle.

Acute Coronary Syndrome

Another heart condition that can be treated with Nitroglycerin is ACS or acute coronary syndrome. The acute coronary syndrome is a condition that further consists of 2 categories: unstable angina and myocardial infarction (heart attack).

Both these conditions i.e.; unstable angina (where the chest pain occurs all the time and doesn’t get better with rest) and myocardial infarction (where the blood supply of the heart is compromised which leads to death of the heart tissue) can be treated with nitroglycerin.

Nitroglycerin widens the coronary arteries (blood vessels of the heart), increases blood flow to the heart muscle, and relieves chest pain. Along with other medications and interventions, it is frequently administered in emergencies to stabilize the patient and minimize cardiac injury.

Recommended Dosage

Nitroglycerin dosage varies depending on the formulation, the severity of the condition, and individual patient factors. It is essential to adhere to the healthcare provider’s instructions and the prescribed dosage schedule.

Sublingual Tablets and Sprays

Sublingual tablets or sprays are typically used for the immediate relief of angina symptoms. The therapy usually begins with 0.3 and 0.6 milligrams (mg) put under the tongue or sprayed onto the oral mucosa.

The patient needs to be counseled on how to use the sprays. It is advised to shake the spray bottle and spray 2-3 puffs under the tongue and close the mouth. If the chest pain is not relieved, the patient needs to repeat the process 3 times and if it still doesn’t relieve chest pain, the patient must be brought to the emergency to seek medical attention.

Long-Acting Formulations

Long-acting nitroglycerin formulations, including ointments, patches, and extended-release tablets, are used for prevention and to reduce the frequency of angina attacks. The dosage and application method of these long-acting forms of nitroglycerin may vary based on the formulation. It is essential to read and adhere to the provided instructions, as well as consult a healthcare professional for individualized direction.

Potential Side Effects

Some individuals may experience certain side effects from nitroglycerin. Not everyone who takes nitroglycerin experiences some side effects, but it is important to be aware of them. Medical attention is required if a person experienced any of the following side effects of this medicine.

Headache

Many people who take nitroglycerin have reported that they experience frequent headaches. This headache is typically mild to moderate in severity and tends to improve as treatment continues. Although not harmful, if the headache persists for a longer time or worsens, you must seek medical attention to know the cause.

Dizziness

Some people have reportedly experienced dizziness, lightheadedness, or a fainting sensation, particularly when standing up from a sitting position or changing positions rapidly. It is crucial to rise cautiously from a seated or lying position to reduce the risk of falls or accidents. If these symptoms persist for a long time or affect your daily life in a way, it is advised to seek medical attention as soon as possible.

Flushing

Some individuals who use nitroglycerin may experience facial flushing or a warm sensation. This effect is transient and typically fades away on its own. Consult a health care professional if the blush is severe or accompanied by other concerning symptoms.

Low Blood Pressure

Nitroglycerin can decrease blood pressure, resulting in hypotension. Low blood pressure can manifest as weakness, vertigo, blurred vision, confusion, or syncope. If these symptoms occur, it is essential to obtain immediate medical attention.

Tolerance

Some individuals may develop tolerance to the effects of nitroglycerin after being exposed to it for a prolonged period. This can result in a decreased response to the medication and a diminished ability to improve the symptoms it is being used for. If a decrease in the efficacy of nitroglycerin is observed, it is essential to notify your healthcare provider for further evaluation and possible treatment modification.

A video about how nitroglycerin works in angina pain

Frequent-Asked Questions

Can I use Nitroglycerin to treat chest pain that is not angina? 

No, nitroglycerin is used and prescribed by doctors specifically for the treatment and prevention of chest pain which is associated with angina. If you experience chest pain or distress that you think is related to angina, you must get yourself checked by a healthcare professional, and if it is not related to angina, your healthcare provider will guide you for a proper diagnosis and treatment.

Can Nitroglycerin interact with other drugs?

Yes, nitroglycerin has the potential to interact with medications, such as the ones used to treat erectile dysfunction (such as sildenafil), high blood pressure, and migraines. It is essential to inform your healthcare provider of all medications you are currently taking to prevent potential drug interactions.

Can I take nitroglycerin during pregnancy or if I am breastfeeding?

If you are pregnant or are currently feeding a child, you must discuss this with your healthcare provider. If necessary, your healthcare provider may change or adjust the dosage of the medicine. To ensure the safety of both the mother and the child, the potential risks and benefits must be meticulously evaluated.

Can I consume alcoholic beverages while on nitroglycerin?

While taking nitroglycerin, extensive alcohol consumption should be avoided. Alcohol can intensify the hypotensive effects (low blood pressure) of nitroglycerin, thereby increasing the risk of other adverse effects. Consult a physician before consuming alcohol while taking nitroglycerin.

Conclusion

In short, patients with angina pectoris, congestive heart failure, and acute coronary syndrome can benefit from Nitroglycin. It can improve the symptoms of all these conditions which most commonly include shortness of breath and chest pain. Nitroglycerin reduces cardiac exertion which came be due to the compromised blood flow to the heart and improves cardiovascular function as a whole by dilatation of blood vessels and enhancement of blood flow to the heart and to the entire body.

To make sure that no side effects or drug interactions occur, it is important to follow the recommended dosages and adhere to the way of utilizing this medicine. You must also openly communicate with your healthcare provider and discuss your concerns related to the medicine. Consult your healthcare provider for personalized guidance and support if you have any concerns or inquiries about your medication.

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