Nitroglycerin: properties, indications and contraindications, how to apply in various forms and cases. Nitroglycerin - indications for use in tablets and ampoules contraindications for the use of nitroglycerin are
The drug is already the second century quickly and effectively facilitates the life of patients with heart disease. But the study and creation of all kinds of pharmacological shapes continues. During the long time, scientists and physicians discovered many favorable properties and found out that nitroglycerin helps, affecting the vascular system.
How nitroglycerin acts
The mechanism of action of nitroglycerin from the end of the twentieth century is no longer a mystery. Scientists discontinued it were awarded the Nobel Prize. The medicine has a relaxing effect on the smooth muscle layer of the vascular wall, due to which the clearance of the vessel becomes wider.
The reason for this is a nitrogen-free nitroglycerin. It reacts with free oxygen and forms nitrogen oxide, which activates a special substance - a guanillatcyclase that is responsible in the body for relaxing smooth muscles.
Nitroglycerin - from which the drug helps
Smooth muscle fibers are located not only in vessels. They also contain the walls of the intestines, bronchi, ureters, biliary and pancreatic ducts. Applying nitroglycerin, you can remove the spasm of these anatomical formations.
- The cardiovascular system. The main and most frequently used "target" nitroglycerin.
- Expanding coronary arteryThe drug increases the inflow of blood rich blood to the heart muscle. As a result, angina patient pain is stopped.
- Expansion of venous vessels, especially when intravenous administration Medicines, reduces the venous return to the heart, "unloading" his right departments. Outcome - Reduction stagnation, prevent of edema of the lungs. In addition, with a reduction in the load of blood on the heart, its need for oxygen is respectively decreasing, which also has an anesthetic effect during angina.
- The drug is used in operational interventions for conducting controlled hypotension.
- The rehabilitation period after a heart attack is also not without this drug.
- Hypertensive disease accompanied by crises with pain in the heart and shortness of breath is also an indication for the use of nitroglycerin.
- Bile and pancreatic ducts. Nitroglycerin removes the spasm of the walls of the ducts during bark colic, dyskinesia of the gallbladder or acute pancreatitis.
- Gastrointestinal tract. The drug facilitates pain during colic and disconesia.
- Urinary ducts. Relaxing the walls of the ureter, nitroglycerin weakens pain with renal colic.
Side effect
The wonderful property of the drug relax a smooth muscles can cause and unpleasant consequences. Cause - Fast Vessel Extension, Fall arterial pressure
- Headache, consentable states.
- Heart palpitations.
- Nausea, dyspepsia, dryness sensation in the mouth.
Overdose can cause nervous excitement, disorientation or inhibition. In severe intoxication, a collapse is observed, a breaking disorder that requires immediate medical care.
For funding conditioncaused by the reception of nitroglycerin, it is necessary to stop the receipt of the drug into the body, the patient is to put with raised legs and a slightly lowered head. Normalization of blood pressure usually occurs within 20 minutes.
Reception rules
For more than a hundred years, the pharmaceutical industry produced a wide variety of forms of the drug. The most popular and effective - sublingual and buccal. It is also produced intravenous and ache, as well as prologue forms.
How to take nitroglycerin in tablets under the tongue
Sublingual tablets of 0.5 mg. They should be taken to relieve angina patient pain. Fast action drug.
Rules of reception. When attacking the type of angina, it is necessary to stop the load during which it arose, sit down and put 1 tablet nitroglycerin under the tongue. The patient will feature the effect in 1-3 minutes. Duration - up to 10 minutes. If it did not help, you can take 5 minutes after the first, take the second tablet, after another 5 minutes the third. The lack of anesthesia for 15 minutes when using 3 tablets - the reason to appeal for medical care, as it is possible to develop myocardial infarction.
Storage conditions for tablets should be followed:
- in open packaging (glass tube) nitroglycerin retains activity no more than two months;
- plastic packaging for nitroglycerin are not suitable, in three days of storage, it loses 80% effectiveness;
- the glass tube must be closed with a rubber plug, without cotton, which absorbs nitroglycerin;
- Unlocked packaging for a week loses 32% of activity.
Of side Effects Most often headaches arise, a feeling of cutting, noise in the ears, redness of the face. Perhaps dizziness, hypotension. This is due to the expansion of venous vessels in the head and the difficulty of venous outflow.
To reduce side effects, it is possible to take half the nitroglycerin tablets by adding validol or menthol to help improve the venous outflow from the skull cavity.
Other nitroglycerin forms providing a quick effect
Under the language you can take not only pills. Also produced alcohol solution of nitroglycerin, oil solution in gelatin capsules, spray and aerosol, plates glued to the gum
- Alcohol solution. 4 drops of solution are dripped on a slice of sugar (some patients are grabbed and 2-3), put under the tongue. Just like with sublingual pills, a three-time reception is allowed for 15 minutes in the absence of due effect.
- Gelatin capsules with oil scene. Application provides for the premises of the pre-crushed capsule under the teeth.
- Inhalation forms. Spray and aerosol at 1 spraying are isolated 0.4 and 0.2 mg nitroglycerin. One sublingual tablet corresponds 2-4 pressing valve. The spray effect comes faster and keeps up to 20 minutes. The drug has proven itself in the edema of light and cardiac asthma. The drug is sprayed into the oral cavity, delaying breathing. When inhalation of aerosol, bronchospasm is possible.
- Plates on the gum. Contain 4, 2 or 1 mg of nitroglycerin. Polymer plates glued on the gum upper jaw In the zone of fangs and small indigenous teeth. The effect occurs within 1 or 2 minutes, and the entire period of the resorption of the plate lasts. It is individual and, depending on this, the dose of the drug is selected. If the resorption occurs within one and a half hours, a plate is prescribed with a preparation content of 1 mg, 2-3 h - twice as much, 4-6 hours - 4 mg. If the load is corrective, stopped before, the plate makes sense to remove. If it is necessary to increase the arrival of nitroglycerin, it is necessary to lick the plate two or three times.
Contraindications for receiving nitroglycerin
Reception of nitroglycerin may worsen the condition of patients when
- increased intracranial pressure;
- hemorrhage into the brain;
- allergies for nitrates;
- hypotension below 100/60 mm Hg. st.;
- hypovolemia FLVD is less than 4-5 mm Hg. st.;
- clotted Glaucoma with high intraocular pressure;
- pregnancy, lactation;
- hypertrophic cardiomyopathy;
- pronounced renal and liver failure;
- thyrotoxicosis.
The use of nitroglycerin, as well as other medicines, must be agreed with the doctor after a thorough examination and establishing an accurate diagnosis.
Nitroglycerin is a drug tool comprising a nitric acid compound and glycerol ester. For 150 years, the medicine is widely used to quickly eliminate pain in the heart. A wide list of indications for the use of "nitroglycerin" allows the use of means for the treatment of cardiac patients. Common use is explained by its vasodilators and antispasmodic properties. But before using Nitroglycerin, it is recommended to carefully read his instructions for use. It will determine what "nitroglycerin" helps, in what cases is contraindicated, what is the mechanism of action from Nitroglycerin.
Nitroglycerin is a drug relating to the nitrate group, has a metropolitan effect. The mechanism of action "Nitroglycerin" has the following:
- It is due to the structure of the drug with nitrogen, which in compound with oxygen creates a new chemical substance - nitrogen oxide.
- It is a natural relaxator of the endothelial layer blood vessels Due to the activation of the guanillaziclase system. In connection with the increase in the CGMF, there is an expansion of smooth muscle structures, especially the fibers of the veins. In parallel under the influence of the drug, the muscles of the gastrointestinal tract, bronchi, biliary ducts and urinary tract. Intravenous administration allows you to expand peripheral veins, which reduces the overload of the heart.
As a result of the extension of blood vessels in the right of atrium, blood flow decreases, the pressure is reduced in the pulmonary circle of blood circulation, as a result of which the manifestations of symptoms in the edema of the lungs become not so sharp. On a plot with reduced blood supply, the blood flow is redistributed, pressure in the chambers is reduced, the voltage and the load on the heart is removed, this reduces the need for myocardial oxygen. The drug brakes the negative effect on the sympathetic fibers of the vessels, which contributes to the removal of pain syndrome. Due to the use of medication, cerebral vessels are expanded, so sometimes after its admission there is a headache.
Due to the properties to remove the tone of the walls of the coronary vessels and expand their lumen. The drug is prescribed to people with various heart disease to relieve the manifestations of the angina of any type, relieving pain, improvement of the state after a heart attack.
Existing forms of release
The speed of absorption and activity is due to the form of a drug and the option of its application. "Nitroglycerin" form of release:
- With sublingual reception (under the tongue) of tableted forms or capsules, the drug is completely absorbed. Its influence is felt in a minute - one and a half after dissolving in the oral cavity, the duration of exposure is about half an hour. Bioavailability - 100%. After 5 minutes, the active substance, reaching the maximum concentration in the blood plasma, is associated with proteins by 60%.
- When used inside the tablets with the shell for a prolonged action, the substance passing through the digestion system is absorbed into the blood in thin intestines. Begins to act half an hour after swallowing, bioavailability is no more than 10%.
- "Nitroglycerin" spray after spraying on the mucous membrane under the tongue is quickly and fully absorbed, the medication in the bloodstream is almost immediately, the plasma accumulates at the maximum after 4 minutes. When removing the kidneys from the body, there is less than 1% of the accepted volume.
- The film for sticking on the gum will stop the attack in a minute - one and a half.
- The concentrated injection fluid is entered directly into the vein.
- Ointment is used externally (also for treating hemorrhoids). The effect is observed after a quarter of an hour, maximum in an hour. The drug is valid until 5 hours.
The transdermal system is represented by a multi-layer plaster. The use of "nitroglycerin" through the skin provides a permanent release of the drug. Gradual arrival active component In the blood vessels of the dermis ensures its presence in the vascular bed in a stable concentration during the entire period, while the plaster is on the skin. The dose depends on the size of the area, which covers the plaster. The result after sticking is manifested in half an hour (the maximum time reaches 3 hours), the action "nitroglycerin" is preserved up to 10 hours.
Metabolized means in the liver, from the body is excreted by the kidneys. Taking "nitroglycerin", it is important to remember that its long-term use, especially prolonged forms, forms tolerance (stability) to the component. As a result, there is a decrease in productivity. Therefore, during the taking medication, the doctor recommends pauses in its use for 8 to 12 hours.
Indications
The testimony for the use of nitroglycerin includes:
- prevention and treatment of the attack of angina;
- myocardial infarction and post-infarction period;
- blockage of the artery of the retina;
- dyskinesia biliary ducts;
- acute pancreatic insufficiency, accompanied by swelling of the lungs.
The drug is used in surgical operations to prevent blood loss.
Pickified reception
Nitroglycerin Instructions contains the following data on receiving rules:
Tableled forms
How to take a capsule or pill sublingual? At the moment when cardiac pain appeared, the drug is placed under the dosage of 0.5 to 1 mg. If pain syndrome does not leave, it is allowed to use another 0.5 mg in 5 minutes. Repeated dose is permissible after half an hour. Upon the occurrence of a positive result, if the tablet did not have time to dissolve, it must be removed from the mouth. How many pills allowed to accept once? For one attack, no more than 3 pieces are used. If the effect has not come, most likely, the infarction has developed. Requires urgent health care.
When pain in the heart arise often, the doctor prescribes in preventive purposes Medicine prolonged action. Repends is available in 2.6 mg tablets. Reception "Nitroglycerin" is carried out at least 3 times per day. With severe flow, the dosage increases twice. But if the attack develops, you can additionally take one tablet under the tongue. "Nitroglycerin" prolonged should be swallowed, so its action comes later, since part of the active component is inactivated in the liver. Medication tools shown to prevent the attack before emotional or exercise.
Nitroglycerin aerosol
Released in the cannuts, suggests sublingual use. A convenient form allows you to quickly introduce the necessary dose to eliminate the attack of angina and in the development of pulmonary edema. Nitrosprey is introduced according to the instructions for use: sitting, shaking the spray, one or two pages of the dispenser spray the drug in the mouth. Breathing is required to delay, you do not need to swallow right away. During strong heart pains, nitrospreys also use. The instruction allows you to use up to 3 presses with an interval of 5 minutes. With the edema of the lungs, the maximum volume is 4 dosages. The medicine can be used in the amount of one dose for prophylaxis before stress or exercise in 5 minutes.
Film
The composition of "nitroglycerin" from the bi-soluble polymer ("Trinitolong") has the following: 1 - 2 mg of the current component. The film is glued on the mucous top gum. After appearance painful sensations It is pressed for a few seconds. To increase the absorption speed, it can be tangled for a couple of times, trying not to move off. When the pain passed, and the film did not dissolve, it is removed. If the effect has not come for 5 minutes, it is allowed to take advantage of the medicine again. After two-time unsuccessful use, immediate medical care is required.
Drops
Drops are 1% nitroglycerin solution on alcohol. They are used sublawable to relieve pain. One or two drops are applied to a piece of sugar, it is put in the mouth and dissolve before dissolution.
Ointment
How to apply ointment with nitroglycerin? Initially, for the drive use, the permissible volume of the agent is 2.5 cm of the column. If the dosage is not sufficient, it is gradually increased by half, it is permissible to apply to 10 cm per day. Ointment is extruded on dosing paper, attached to skin without hair.
Intravenously
Intravenously "nitroglycerin" is introduced, individually selecting the rate of receipt of the solution into the blood. For this, a special dispenser or dropper is applied. In the latter case, drops of drops. The initial rate of administration is 5 μg / min. In the future, after 3 - 5 minutes it increases. The figure will depend on the body's reaction - pressure and heart rate indicators. The duration of treatment is usually up to 3 days. If necessary, the introduction renews.
Interaction
At the reception at the cardiologist it is important to tell about all the accepted drugs so that unwanted reactions do not occur:
- The use of "nitroglycerin" in parallel with vasodilatory meansSome types of antidepressants, pills against arrhythmia, diuretics or drugs from pressure and beta-blockers enhances the hypotensive effect.
- With simultaneous reception with salicylate, the concentration of the drug increases.
- With intravenous administration, the means reduces the effect of "heparin".
Nitroglycerin can not be applied with alcohol, as the danger of hypotension is increasing. Especially since such a disease of the heart implies a refusal of alcohol-containing drinks, as the product negatively affects the condition and operation of the organ. The air temperature should also be taken into account: in the warm season, in hot weather, there is also a sharp decline in pressure.
Contraindications
It has "nitroglycerin" and contraindications. The drug is not prescribed in the following cases:
- in the intolerance of nitrates;
- under hypotension;
- with galactosemia;
- under Tamponade Pericarda;
- with adhesive pericardius;
- during the intake of phosphodiesterase inhibitors.
With extreme caution applied at:
- increased eye and intracranial pressure;
- tendency to hypotension;
- stagnant phenomena in the right ventricle of the heart;
- low hemoglobin;
- hyperthyroidism;
- severe diseases of the kidneys and liver;
- cordic valves.
Nitroglycerin is prescribed during pregnancy and lactation, also for young people earlier than 18 years.
Side effects
For side effects after using Nitroglycerin include:
- The nervous system is concerned about dizziness coming by headaches, a feeling of cutting inside the head, weakness, the development of paradoxical effects.
- The heart and vessels can respond with tides to the surface of the skin, hypotension, heartbeat.
- The digestive organs react with nausea, dry mouth, sometimes vomiting, diarrhea.
- Allergy is expressed by itching, contact dermatitis is not excluded when using the civic forms.
When glauer is possible to reduce vision and aggravation of the disease.
Overdose "Nitroglycerin"
You can get an excess dose of medication by taking it in any form, while the collapse occurs. The condition is characterized by a sharp decrease in pressure when rolling. Also an overdose "nitroglycerin" manifests itself:
- increasing weakness;
- lowering blood pressure indicators;
- in the blood of methemoglobin;
- shortness of breath and burning throat;
- swelling on the skin;
- the development of cyanosis (the appearance of crushing areas on the skin);
- hypothermia;
- ischemia, the development of a heart attack with a sudden fatal outcome is not excluded.
The drug relates to toxic substances, since suction through the mucous surface occurs quickly. The amount of medication capable of causing nitroglycerin poisoning is from 25 to 75 mg.
Mortal dose "Nitroglycerin"
At the nitroglycerin medication, the deadly dose is also there, because this chemical has actively affects the body. For each person, these indicators are individual. Strong poisoning is developing if you drink 100 - 150 mg / kg, with a fatal outcome is possible. When taking orally, 210 mg / kg death occurs after 2 minutes. Situations are noted when the death of the patient occurred when using the recommended dose, but the interval between the techniques was not respected.
Any form "nitroglycerin" requires the appointment of a doctor in a strictly indicated dosage. Alone drink the drug if the doctor recommended its use during attacks or as prevention. If the action "nitroglycerin" does not appear, cause ambulance.
Nitroglycerin is a drug of synthetic origin, which is used in cardiology. Released in form alcohol solution, sublingual pills and capsules.
Pharmacological action Nitroglycerin
According to the instructions, the active active component of the drug is nitroglycerin.
The drug is a peripheral vasodilatologist affecting venous vessels. Nitroglycerin forms nitrogen oxide, which leads to activation of guanillates and an increase in the content of cyclic guanosine monophosphate (CGMF) in smooth muscle cells. In accordance with the instruction, nitroglycerin contributes to the non-specific relaxation of the smooth muscles of vessels, more venous, which is accompanied by blood deposit in the venous system.
When using nitroglycerin, there is a decrease in the preload of the heart and the final diastolic filling of the left ventricle. Common systemic arterial dilatation, predominantly large vessels, provides a decrease in post-load.
This medication reduces the need of myocardium in oxygen, normalizes the operation of systemic blood flow.
When using nitroglycerin, there is a relaxation of the smooth muscles of the biliary tract, bronchi, intestines, stomach, esophagus, the urogenital system.
Nitroglycerin is quickly and completely absorbed into systemic blood flow. The period of complete removal of the drug is 8 hours. It is derived from the body in the form of metabolites by kidney.
Indications for the use of nitroglycerin
Nitroglycerin's testimony are angina attacks, left-told deficiency, myocardial infarction.
In individual cases, the medicine is used to treat dyskinesia of biliary tract. In some cases, prescribed for therapy of the central artery of the retina eye.
Method of application and dosage
Nitroglycerin in the form of an alcohol solution is applied directly into a language of 1-2 drops or wet with them a small piece of sugar and kept under the tongue before its complete resorption. Maximum one-time dose of nitroglycerin under tongue - 4 drops, daily - 16 drops.
According to the testimony of nitroglycerin in tablets, they take sublingual, immediately after the occurrence of pain, not swallowing. Motherwise dose Nitroglycerin in adult tablets is 1-2 pieces. Maximum daily dose - 6 tablets.
Rules for receiving capsules comply with the rules for receiving tablets. To accelerate the therapeutic effect, the capsule can be crushed with teeth.
The duration and frequency of nitroglycerin is dependent on the intensity and frequency of anginaartic seizures.
In the absence of an effect for 5 minutes after receiving the medication, it is necessary to take another 1 tablet. In the absence of an effect after receiving 2-3, the tablets should immediately cause ambulance.
Side effects
When applying nitroglycerin, headaches, tachycardia, noise in ears, heat, decrease in blood pressure, dry mouth, abdominal pain, nausea, vomiting.
Contraindications
According to the instructions, nitroglycerin is not prescribed to people who have:
- Arterial hypotension;
- Brain circulation disorders;
- Hyperthyroidism;
- Clotted form of glaucoma, accompanied by increased intraocular pressure;
- Idiopathic hypertrophic subportal stenosis;
- Head injuries;
- Hemorrhagic stroke;
- Severe anemia;
- Subarachnoid hemorrhage;
- Collapse;
- Heart failure;
- Uncontrollable hypovolemia;
- Constrictive pericarditis;
- Isolated mitral stenosis;
- Heart Tamponade;
- Card-brain hypertension.
Nitroglycerin's contraindications are also age up to 18 years old, pregnancy, lactation period.
Caution takes medicine with liver failure and severe renal failure.
Overdose
Under the overdose of nitroglycerin, it is possible to reduce blood pressure, reflex tachycardia, asthenia.
Nitroglycerin overdose symptoms are also dizziness, cyanosis, dysnae, methemoglobinemia, tachipne.
Additional Information
The uncontrolled nitroglycerin intake can cause the development of tolerance to the drug.
The medicine affects the speed of psychomotor reactions, so during therapy it is recommended to refrain from controlling heavy mechanisms and vehicles.
According to the Nitroglycerin instructions, it is necessary to store in the cool and inaccessible place for children.
Shelf life - 2 years.
Nitroglycerin is released from pharmacies in non-prescription.
With the abrasion of the cardiovascular system are in the first places in the number of deaths.
Causes here are three:
- The key is the insufficient degree of attention to your own health. Which is especially typical for the post-Soviet space with low level medical culture population.
- The second is the mysterityptomaticity of pathologies, which does not allow to react on time.
- The third is the unqualified actions of the doctors or the inattention of the patient himself. This reason concerns poor-quality first aid, improper use of medicines.
Further development of the pathological process, the prospects for recovery depends on qualified events.
Nitroglycerin is a primary tool, emergency For diseases of the cardiovascular system. Basically, he is considered as pharmaceutical preparation With pain in the heart to relieve a discomfort, which is true only in some part. In fact, the clinical effect is much wider.
Medical remedy exists in several species. Each is used in a specific group of clinical situations, the question is not so obvious at first glance, when reading the instructions, the findings cannot be made. This moment should be considered more.
- Solutions. On water, oil and alcohol. The first is used for injecting administration, so it makes sense to assign it in urgent cases.
There is a small period of time, ideal for emergency help in place or in the intensive care unit, during intensive therapy.
- Tablets and capsules. There are forms of S. short action and a prolonged effect that has been saved by many hours. The choice depends on the targets of therapy.
Not always nitroglycerin is assigned to relieve urgent state.
Reception is possible during a long period, as an integral part of the therapy of dysfunctional disorders, ischemic Disease Hearts, in the rehabilitation period after a heart attack.
- Patch. Also has a long influence on the body.
- Ointment. Used relatively rarely. Almost never in cardiovascular diseases, because this form has a local impact.
Strictly speaking, nitroglycerin is applied not only as part of the treatment of heart disease and vessels. But even with some other deviations in the work of the body (see below).
- Spray can.
A specific form of release depends on the needs and purposes of the therapeutic course.
Funds with a short effect are good for emergency care.
The prolonged type was widely used in chronic disorders therapy, in the framework of multi-month reception.
As for the composition, the name belongs to organic nitrates. As follows from the name of the group of compounds, these are substances based on nitrogen. In this case, its oxide.
The pharmacological effect is to relax and expand the vessels, mainly veins, due to which local blood flow is normalized. The quality of breathing and cellular nutrition directly depends on this.
Indications for use and dosage
The grounds for the use of nitroglycerin are many, which causes its wide appointment in the practice of cardiologists and specialists of some other profiles.
- Angina. A variety of coronary failure, when blood comes to the heart in a small volume due to the stenosis (narrowing) of the arteries by which it moves. Nitroglycerin when used in tablets in an amount of 1-2 with an interval of at least 10-20 minutes. Or 4-6 drops in solution. Injection administration is practiced only by doctors, because there is no point in knowledge of the dosage.
- Chronic heart failure. Allows partially to normalize tissue trophy (food). Not suitable for use in the long run, because clinical efficacy is not always sufficient, but risks side phenomena remain high. The question is solved at the discretion of the doctor. Application form - tablets or prolonged capsules. It is enough to drink 1-2 tablets per day.
- Heart attack. If nitroglycerin is almost always used, and helps well, with a heart attack, the task is much more difficult, depending on the cause and form of the necrosis of the tissue of the muscular organ, possible Full ban on the use of nitrates.
In some situations, it will provoke even greater ischemia of tissues and rapid motion of cardiomyocyte cells.
Use is permissible only with the permission of the attending specialist. Basically in the form of an injection solution.
At your own fear and risk, patients take 1-2 tablets. The scheme is about the same as with the help of angina.
- Elevation of the lungs, the attack of cardiovascular asthma. Used with urgent events. The maximum permissible number of tablets in this case is 3-4, drops - not more than 16. The volume of application depend on the state of the patient, the pathological process provoked a dangerous violation.
There are other diseases that can be the basis for using the name.
The effect of nitroglycerin occurs after 3-7 minutes, regardless of the form, which makes the drug flexible and universal.
- Brain vessel spasms. Including in migraine, although this is not a direct indication. In this case, 1 tablet in the acute phase is sufficient for partial or complete restoration of the normal state of the patient.
- Violation of the tonus of the muscles of the uterus. It may be extremely discomfort, because nitroglycerin is used to relieve an unpleasant feeling. This is not an end in itself. Can act in this way in acute cases, then still need to contact the doctor to establish the cause of deviation.
- Painful spasms of organs and the structures of the excretory system: Ureterals, kidneys and others. In the framework of therapy or in the event that classical medicines like drootaverin, but-shops and other similar groups (spasmolytics) do not help.
- An irritable bowel syndrome, colitis. All states that provoke a spontaneous increase in the tone of the muscles of the digestive organs. Used short time and only to correct discomfort.
- Astmatic attack of unforeseen origin. Against the background of an allergic reaction or infection. It makes sense to take the drug only in extreme cases, if the action of glucocorticoids, brotherlyactors delays or incomplete.
- Problems with a gall bubble. Including stagnation, the so-called cholestasis. It is often found.
In the cases described when cardiac structures are not involved, universal or even approximate dosage is difficult to call. You need to consider too many factors. This is a strictly individual task.
How nitroglycerin acts under different states
Angina
For this reason, the drug is impossible to be called within the framework of the treatment of the disease. This is not true.
But the dosage must be thoroughly varying, if necessary, adjust. It is impossible to do this on your own. Requires help cardiologist.
Pulmonary edema
In such a case, the medication is also perfect: Nitroglycerin will help reduce the pressure in pulmonary artery, Normalize the blood flow in a small circle, which in itself removes swelling and stagnation.
However, with a long-term emergency condition, everything is not so simple. Urgent hospitalization may be required.
Diseases not mentioned above
They were partially affected earlier. If specifying, this list will be released.
- Disruption of the gallbladder. Nitroglycerin relaxes the walls of the ducts withdrawing the secret, expands them, which leads to a rapid assignment, stopping stagnation.
- Intestinal problems. Removes pain syndrome and spasm, normalizes the content of content. In some cases, much more preferable to classic medicines like drootaverine.
- Asthma attacks. Not always and not in all cases. Bringing problems with breathing, the narrowing of the bronchial lumen, contributes to the rapid disorder of sputum.
- Pain syndrome in the region of the uterus in the spasme is also eliminated by using the medication. It is possible to use when disperser, painful menstrual cycles. In coordination with the gynecologist.
- Defeating the kidneys, ureterals, other structures of the excretory system. Normalizes the patient's condition, removes discomfort and restores the destruction of urins.
- Problems with the brain. Removal, which means normalization of cerebral blood flow and elimination of headaches and other neurological manifestations.
It is possible to use nitroglycerin with tachycardia, but this is not a special indication, it is usually eliminated in parallel, within the framework of the main state therapy, which provokes an increased frequency of heart cuts.
Contraindications
Such quite a lot, you need to strictly adhere to the list.
- Stable high or critical intracranial pressure. Confirmed by diagnostic methods.
- Glaucoma even on the background of the therapy. Because like a rapid attack, death eye nerve And irreversible change in vision.
- . Cluster in the pericardia (a special bag that concludes a muscular organ) fluid or blood. Because inevitably the use of nitroglycerin will provoke a fatal outcome as a result of a heart stop (asistolia).
- Incication of metals salts, other poisons with the development of pulmonary edema.
- Cardiomyopathy. Thickening the wall of cardiac structures. Relative contraindication. Depends on the nature of the process and its "launch". Read more about the types of cardiomyopathy and methods of treatment, read.
- Pericarditis. Inflammation of the already named shell bag.
- The drop in blood pressure to critical marks (below 90-100 to 60, depends on the individual characteristics and working blood pressure).
- The same applies to the frequency of muscle contractions. A pronounced clear pathological genesis is contraindicated.
- Nitroglycerin intolerance. Allergic reaction. It is relatively rare, but during development, the drug is canceled and not used, replacing with analogues. Unfortunately to identify the problem without trying, it will not work. Therefore begin with minimal dosage, not counting urgent states.
- Polyvalent response to medicines. Diagnosed even less often. Accompanied by an immune response, allergies immediately to the group of drugs.
In the main part of the described cases, with low pressure, critical small pulse, etc., the application will provoke a fatal outcome.
Therefore, it is impossible to use nitrates without the appointment of a doctor and thorough diagnosis. Especially, not knowing your own organism and current diseases.
There are so-called situations where applications are permissible, but not recommended. There is a standard medical rule: it is possible to take nitroglycerin if the benefits exceed the risk.
- Pregnancy.
- Breast-feeding.
- Age 75+.
- Acute violation of cerebral blood flow or.
- Heavy anemia.
- Renal, liver failure.
- Pronounced intoxication.
Side effects
There are rarely found. Mainly allergic reactions. A little less often develop headaches, discomfort in chest, growth in the number of heart abbreviations. Nausea, vomiting.
Suitable
Nitroglycerin is able to quickly help with heart and some other problems, but the panacea is not considered. Because the effect is partial or absent at all.
For this reason, as well as in view of enormous risks, the speech does not go about any unauthorized application. It is extremely dangerous. In all controversial cases, it is recommended to consult a cardiologist.
Exception is only urgent statesWhen a question is an edge, on horseback life. Then it makes sense to risk and adopt nitroglycerin, but without a call to ambulance and transporting to the hospital, it is still not to do.
Currently, in pharmacies, the shelves are simply bursting from the amount of drugs that are stored on them. Many drugs you can purchase, only having a recipe on your hands, discharged by a doctor, but most of the goods from the available range will be sold without availability. "Nitroglycerin" belongs to freely selling drugs. From what it helps, you can learn from this article. Despite the fame, it is necessary to relate to his reception with extreme caution.
Information about the preparation
Nitroglycerin (group of nitrates) quickly found application. It began to use it even at the end of the 19th century, after the opening of the Italian Askanio Sobero. At first, it was the production of explosives.
After long-term observations of workers in workshops, the Merillian doctor concluded that nitroglycerin's pairs affect human health.
A little later it was found that this substance can be used for medical purposes for the treatment of certain diseases. For example, after reception, it is possible to remove the spectal vessels. With enough, there were several drops of the drug to stop it.
So gradually nitroglycerin began to be used in medical practice.
Today, if you ask any person about Nitroglycerin: "What should I use it?", Then almost everyone will say that it is indispensable for heart attacks. I have not yet come up with another medication, which would have shifted so quickly with angina pain.
Forms of release of drug
Nitroglycerin can be attributed to the grand discoveries in the world of pharmacology, which happen infrequently. During its use, and this has been more than 100 years old, and did not invenize a more effective medication from the "chest toad".
Manufacturers produce various forms and packaging, but they remain the same in the same. Now in pharmacies you can find a fairly large range. Nitroglycerin is produced in the form of tablets that need to be put under the tongue. This is the very first form of the drug.
Now the nitroglycerin plaster has become fashionable, which is enough to join the skin or mucous membrane so that the active ingredient began its healing work. An even more advanced is "nitroglycerin-aerosol". Despite the fact that all these drugs contain the same substance, the cost of them may vary in fairly wide limits.
"Nitroglycerin" - mechanism of action
Many, probably, are asked about what the secret of such an instant action of this medication during cardiac attacks. The whole answer lies in the principle of the drug. Pain with angina occurs as a result of acute oxygen deficiency in the heart muscle. It can be removed only in several ways:
- Increase the inflow of oxygen to the heart.
- Reduce the frequency and strength of heart abbreviations to reduce oxygen consumption.
All this is quite capable of implementing nitroglycerin. After its admission, the production of nitrogen oxide is enhanced, which expands vessels, especially veins. This leads to the fact that the inflow is reduced to the heart muscle venous blood, and the frequency of abbreviations and their strength are reduced. Once less work, then oxygen required less.
But the nitroglycerin medicine also increases the flow of oxygen to the heart due to the expansion of coronary vessels, and this happens more at the place of ischemia, which leads to a rapid relief of the attack of angina.
The effect of drug intake can be observed in a few minutes. Also quickly the exile of the drug from the blood. After 40-45 minutes it will not be a trace.
Indications for use
There are a number of diseases under which nitroglycerin is recommended. Application may require a disposable or long. It can be noted among the readings as follows:
- Any manifestations of angina.
- What can impede intravascular research.
- Myocardial infarction, especially against hypertension.
- Heart failure.
- Neuroglycerin can use in front of neurosurgical operations. The use of it artificially reduce the pressure.
- Arteries spasm in the retina of the eyeball.
- Discower some departments of the digestive system.
When can I take "nitroglycerin"?
It turns out that this medicine can be used not only at moments of cardiac pain, but also in some other cases. For example, for the prevention of an attack, if you have physical work or foresees an emotional stress.
Often it takes patients with a diagnosis of "angina region" when they rises along the steps to the top floor of a multi-storey building. It is recommended to take it in front of the lift to the mountain, especially in winter, frosty and windy weather.
You can not be surprised if the doctor you will add "nitroglycerin" when the pancreatitis. The recipe on Latin, but the provisions in the pharmacy in such records perfectly understand. Such an appointment can be explained by the fact that this drug Perfectly removes the spasm of smooth muscle gasts.
Correct medication
Despite the great popularity of this drug, it is necessary to remember: it is still a medicine, so it is necessary to take it according to certain rules. Only in this case can be guaranteed safety.
The most effective I. fast way Aid is the nitroglycerin tablet under the tongue. Since in a lot of blood vessels, the medicine is almost instantly absorbed into the blood, and relief comes.
If you decide to take the nitroglycerin tablet, then it is better to sit before it. Some can turn the head, and in exceptional cases there are fainting.
In the older age, the reception is better to carry out in the lying position. At the time of the attack, the tablet must act in a couple of minutes. If the pain does not let go, then you can take another one. If after 15 minutes the pain does not pass, you will have to call a doctor, otherwise not far and to
If in your first-aid kit "nitroglycerin" in the form of droplets, then during heart pain, you can drink 2-4 drops on a piece of sugar and keep it under the tongue until dissolved. Some manage to drip directly into the tongue or linen from the tube tube.
It is not necessary to engage in self-medication, even if you are familiar "nitroglycerin". What is recommended to use it - you know, but the wrong dosage is fraught with serious consequences.
Varieties "Nitroglycerin"
Everyone knows that this drug is acting quickly, but not long. Currently created forms that are able to provide their therapeutic effects within a few hours. Nitroglycerin prolonged, for example, "Sustak", Nitrong, Trinitolong can be attributed to these drugs.
They are recommended to apply in advance, they are able to prevent the appearance of an attack within a few hours. Active substance - Nitroglycerin - begins to gradually enter the blood, thus these preparations in the duration of action are many times superior to their original "fellow".
Along with such an advantage, they are still inferior at the speed of action, and this is very important at the time of the attack. This is due to the fact that they are not under the tongue, and they are injected with water, respectively, it is necessary for a certain time that the drug is dissolved and composed into blood.
Therefore, if the attack fighters you suddenly, you can not do without the usual "nitroglycerin" in the form of sub-speaking tablets.
Side effects
In any medicinal preparation You can always find side manifestations. They are indicated in the annotation to the medicine. This, of course, does not mean that one or another effect will manifest itself, but it is necessary to know about them.
The side effect of Nitroglycerin can be explained by the fact that it expands the vessels. You can call the following frequently occurring unwanted manifestations:
The prolonged forms of this drug can cause the same side effects. It is worth noting that with long-term admission to them, addictive is being developed; therefore side effect "Nitroglycerin" and its forms is significantly reduced or disappeared at all.
Frequency of reception of drug
Those patients who suffer from heart attacks often try to endure pain and do not accept "nitroglycerin". But it will not help in this situation. If the attack does not stop, the pain can increase, then it will be much more difficult to eliminate it.
In severe situations, some patients can take more than 50 tablets during the day. Doctors consider such a dose in certain situations quite reasonable.
Most scientists who conduct studies of this drug believe that continuous use of it can lead to an opposite effect - strengthening the frequency of attacks and their strength.
Therefore, to the question of whether Nitroglycerin is possible, the answer suggests only positive, but still do not do this without the recommendation of the doctor and in large doses.
Contraindications for reception
Each drug always has its own list of contraindications, so do not rush to go to the pharmacy and acquire the medicine without a doctor's prescription.
Nitroglycerin in any form is categorically contraindicated in the following diseases:
- Low pressure.
- Anemia.
- Acute myocardial infarction.
- Problems with blood circulation.
- Pulmonary edema.
- Glaucoma.
- Alcoholic intoxication.
- Stroke.
- Vices of the heart.
- Pregnancy.
- Problems with thyroid gland.
- Renal and liver failure.
Do not take "nitroglycerin" in the event that you are treated with Sildenafil preparation.
If you happen and with your history, the reception "nitroglycerin" is contraindicated, it is advisable to discuss with a doctor, which drugs you can be taken in this case.
Poorly tolerated "nitroglycerin"
Some after taking medication feel sharp headache, dizziness and begin to believe that they simply do not fit this drug. But this is explained by his vasodilative action. When recuiting this may not happen, or these symptoms will appear more gently.
If every time you feel bad, you are experiencing a strong pain in my head, then it is worth discussing the feasibility of using this fund.
With frequent attacks of the angina, this drug can only save you at a critical moment, therefore it is not necessary at once at the first manifestations of side effects to refuse it. Try to reduce the dosage and discuss the situation with your doctor.
Storage conditions
After buying any drug It must not only be taken in accordance with the instructions or recommendations of the doctor, but also stored under certain conditions. "Nitroglycerin" can not be left in the light. Under his action, he quickly begins to collapse, the same thing happens in a warm place.
To prevent this, this medicine must be stored in the refrigerator. If the doctor discharged you "nitroglycerin" (recipe on Latin), you will be enough that instruction that is attached to it. There you can read about all the requirements for storage.
In the instructions you can see such an item that recommends to store "nitroglycerin" in the packaging in which it was sold. This can be explained by the fact that the bubble and wool are processed by a special composition, which contributes to the preservation of the properties of the drug.
After you sold off the packaging, Nitroglycerin and, subject to all storage conditions, cannot maintain their healing qualities for a long time., After a couple of months, its effectiveness will fall by 30%. In this regard, the capsule is more resistant.
If you use this medicine quite often, it is quite suitable for pills, and if it is rare, it is better to get a spray that has a long shelf life.
If you do not want to take a whole bubble or packing of tablets on the road, and you solve several pieces to wrap in a napkin and put in your handbag, you may not even try, after such transportation, the drug will not help you.
Despite the fact that most of us know what "nitroglycerin" is, from which it helps does not interfere with once again reminding the features of its use:
- Do not be afraid of a sharp headache after taking the drug, it suggests that the medicine began its work. After several techniques, such sensations stop disturbing you.
- If you suffer angina, then "nitroglycerin" should always be at your hand.
- With heart attacks, it is desirable not to use capsules, they contain an oil solution that is absorbed longer.
- If you take a medicine for a long time, the effect of it is sharply reduced, so it is necessary to take a break.
- In the presence of eye diseases, taking "nitroglycerin" stands with extreme caution.
- When taking this medication, it is better to postpone, otherwise it can fall even more, and a person will lose consciousness.
In the miraculous influence of "Nitroglycerin" no one doubts, because it is not for nothing more than in 100 years, scientists failed to invent more effective drug From angina. But despite all this, the reception must be carried out strictly on the recommendation of the doctor in compliance with all dosages in order not to harm your health.
