Glyceryl trinitrate

Pharmacological properties

Nitroglycerin limits the reflex effect on blood vessels and the heart, redistributes blood flow in the myocardium towards the focus of ischemia. causes a decrease in venous return to the heart. due to this, the end-diastolic pressure of the left ventricle (preload) decreases, and therefore the diastolic volume also decreases. myocardial oxygen demand is reduced at rest, and especially during exercise; in patients with angina pectoris, the ability to tolerate physical activity improves. in addition, nitroglycerin causes vasodilation during vasoconstriction. depending on the dose, nitroglycerin also has an expanding effect on arterioles, resulting in a decrease in systemic vascular resistance (afterload) and systolic pressure in the left ventricle, which reduces the tension of the myocardial walls and reduces myocardial oxygen demand.

Indications

Acute left ventricular failure, including myocardial infarction, cases of severe refractoriness to other drugs, angina pectoris.

Application

1% nitroglycerin concentrate for infusion is diluted in 0.9% sodium chloride solution to a concentration of 0.01% (0.1 mg nitroglycerin in 1 ml of solution). the initial rate of administration of 0.01% solution of nitroglycerin is 25 μg per 1 min (1 ml of 0.01% solution for 4 min).

Contraindications

Cerebral hemorrhage, increased intracranial pressure, severe arterial hypotension, individual intolerance, angle-closure glaucoma with high intraocular pressure.

Side effects

Possible headache, dizziness, sensation of heat, general weakness, a sharp decrease in hell as an orthostatic collapse.