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Nitrates and Nitrites (Nitroglycerin (CONTRAINDICATIONS (Severe Anemia,…
Nitrates and Nitrites
Name
Vaporole
Machanism of action
Amyl nitrite's antianginal action is thought to be the result of a reduction in systemic and pulmonary arterial pressure (afterload) and decreased cardiac output because of peripheral vasodilation, rather than coronary artery dilation. As an antidote (to cyanide poisoning), amyl nitrite promotes formation of methemoglobin, which combines with cyanide to form nontoxic cyanmethemoglobin
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Contraindications
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should be used with great caution in patients with glaucoma, recent head trauma or cerebral hemorrhage.
it can be harmful to the fetus when it is administered to a pregnant woman because it significantly reduces systemic blood pressure and blood wflow on the maternal side of the placenta.
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side effect
throbbing headache, dizziness, weakness
hypotension, reflex tachycardia, syncope
Storage
storage in a dry, clean, well ventilated area at room temperatures between 15° to 25°C
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Nitroglycerin
INDICATIONS
for the acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.
CONTRAINDICATIONS
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patients who are allergic to nitroglycerin, other nitrates or nitrites or any excipient.
Mechanism Of Action
Nitroglycerin forms free radical nitric oxide (NO) which activates guanylate cyclase, resulting in an increase of guanosine 3'5' monophosphate (cyclic GMP) in smooth muscle and other tissues. These events lead to dephosphorylation of myosin light chains, which regulate the contractile state in smooth muscle, and result in vasodilatation.
SIDE EFFECTS
Vertigo, dizziness, weakness, palpitation
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Flushing, drug rash, and exfoliative dermatitis have been reported in patients receiving nitrate therapy.
Storage
Store at Controlled Room Temperature 20°–25°C . Nitroglycerin should be kept in the original glass container and must be tightly capped after each use to prevent loss of tablet potency.
ADMINISTRATION
Administer one tablet under the tongue or in the buccal pouch at the first sign of an acute anginal attack. Allow tablet to dissolve without swallowing. One additional tablet may be administered every 5 minutes until relief is obtained. No more than three tablets are recommended within a 15-minute period.