Nitroglycerin -- a solution for the angina pains

Cardiac patients learn very quickly and very well their symptoms and can easily assimilate the treatment and remember it. Nitroglycerine (known among others as Nitrospan, Nitrostat, and Tridil) is used as a medicine for angina pectoris. Doctors prescribe it and teach the patient that it should be taken only in case he or she feels an approaching angina attack (ischemic heart disease). The drug is also popular under the names Nitro or Glyceryl Trinitrate.

It is used as a medicine in tablets (sublingually - under the tongue), ointments, intravenous solutions, sprays administered sublingually, and transdermal patches (Nitro-Dur, Transderm-Nitro) Nitro is used with success in treating chest pain starting from 1870
The drug is metabolized in the liver, the half time being 3 minutes (rapid).

Why Nitroglycerine is used in Angina?

The reason why Nitro is used in Angina and ischemic pain is because of its vasodilatative property. Nitroglycerine dilates veins more than arteries, decreasing the cardiac preload and thus inducing a therapeutic effect on the cardiac muscle. Benefic effects of Nitroglycerine are:

• Increases the heart rate and the pulse - this way it prevents a bradycardia
• Decreases the blood pressure, and this is very important because associated hypertension in patients with ischemic disease is unwanted and may induce severe complicaitons
• Prevents the chest pain, angina pectoris. Patients usually feel how the drug is decreasing the pain after a few minutes. If the drug is administered sublingually (for a better and faster absorption), than patients feel the benefic effects in minutes

Nitroglycerine is used more to prevent the angina attack rather than reversing a started one.

What is the mechanism on Nitro in our organism?

Well, as far as I know, the complete mechanism of Nitroglycerine wasn't yet completely discovered, but it was established that after being absorbed, the Glyceril Trinitrate (pharmacological name of the substance), it is converted into nitric acid which is a natural vasodilator (dilates veins and arteries).

Nitroglycerine - Pros and Cons

There are advantages and disadvantages in using Nitroglycerine as a solution in preventing chest pains. As advantages I could add:

• it is cheap and relatively accessible to any patient
• it is produced in tablets and it makes Nitro an easy to use drug
• it is fast and cuts the chest pain in less than three minutes

But, of course, there are some several disadvantages in using Nitroglycerine:

• It can induce tolerance in time, and this reduces its effectiveness. Tolerance may require higher doses in time to achieve the same effect as initially.
• In some rare cases, Nitroglycerine can induce headaches, bradycardia, severe hypotension

Some other usages of Nitroglycerine

Nitroglycerine is not only used in angina attacks, but also in

• Anal fissure treatment, first study of this type was carried by Queen Elizabeth Hospital, King's Lynn, UK
• Nitroglycerine patches have found their use as a solution against the bites of Brown Recluse Spider, which poison has a vasoconstrictor property and Nitroglycerine induces the opposite effect.
• In Durex condoms - at the top of them in small amounts. Nitroglycerine plays the role of a vasodilating drug this way maintaining the erection during intercourse, because it is absorbed in the skin

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