There was a time when only a fewThey produce it in very small doses. And he was then the basis for the production of dynamite. The enormous destructive power lay in the nitroglycerin. But if you take the substance in very small doses, it becomes a drug that can save lives in some cases.
mymedinform.com offers to talk about nitroglycerin, its pharmacological properties, methods of application, contraindications and adverse effects.
A little history
Glyceryl trinitrate, namely it isNitroglycerin active substance was first obtained by chemist Ascanio Sobrero from Italy in 1847. Formed this ester with glycerol and the reaction of nitric acid and was used initially only as explosives. By the way, Sobrero noticed that if you try the language of a small amount of this substance, there is a strong headache. Constantine Hering in 1849 when studiesin volunteers has confirmed that the material contributes to the appearance of headache. He hoped to use nitroglycerin as a means of homeopathy in the treatment of headaches, guided by the principle that "like should be treated similarly." Goering gave substance called "Glonoin", it is used in homeopathy and now. In 1851, Alfred Nobel began manufacturing nitroglycerin as an explosive in Sweden, patenting his method of production. Fate is ironic - Nobel, who suffered from heart attacks, rejected at that time the use of nitroglycerin as a drug. William Merrell (English doctor), monitor the status of the workers engaged in the production of nitroglycerine, I noticed that a pair of substances affect their health. This doctor for the first time in 1876 used this tool to remove the attack "angina pectoris" (so called angina in the 19 th century). The patient was dripped into the language of one or two drops of glycerine trinitrate, followed by pain in the heart abated. Later the solid form of the drug has been developed. One of the well-known US companies in 1882, started to manufacture nitroglycerin medication in five different dosages. And so it went Nitroglycerin into medical practice. In 1998, Louis Ignarro, Robert Ferchgott, Ferid Murad were awarded the Nobel Prize for revealing the secrets of the effect of nitroglycerin (more precisely, the released nitrogen oxide with a valence II) on vascular tone.
The use of drugs like nitroglycerin
It is a vasodilator (peripheral vasodilator), widely used in cardiology, belong to the group of organic nitrates.
The analgesic effect of the drug isvery quickly (1.5-2 minutes) and 45 minutes from the traces of the drug in the blood is gone. It affects mainly in the coronary arteries, and venous vessels in the brain vessels. When taking the drug there is a redistribution of coronary blood flow, that is, the blood carries nutrients and oxygen directly to the ischemic areas of the myocardium. In the small circle of blood pressure decreases. Besides drugs Nitroglycerin relaxes smooth muscles of the biliary tract, gastrointestinal tract and other organs.
In some cases, you can resort to using nitroglycerin?
- When vascular spasm of the heart to remove (orwarn) angina, to stop the pain of cardiac origin. Many cores are taking nitroglycerin tablet under the tongue to prevent angina, if they are to emotional or physical activity (for example, before the rise of the hill, up the stairs, to the exciting public speaking).
- at myocardial infarction, Left ventricular failure.
- When biliary dyskinesia, hepatic colic, acute pancreatitis.
- Embolism occurred in the eyes of the central retinal artery.
- Pulmonary edema.
How to take the medicine?
Available in the form of drug dosingsublingual spray, tablets, drops, capsules, applied sublingually (under the tongue that is), films (to be applied on the gums), the concentrate used to prepare the solution for injection, tablets, sustained release.
One sublingual tablet contains only 0.5 mg of active substance, besides which it contains glucose, 25 povidone, lactose, crospovidone, macrogol 6000.
To remedy was effective, broughtfavor, you should know the rules of its reception. If you have a pain in my heart, when you gave the body exercise (or subjected to emotional stress), first calm down, stop the load for a few minutes. At this time, put under the tongue one tabletochku Nitroglycerin or capsule. Under the tongue mucosa is well equipped with blood vessels, so it is very fast (about two minutes) will resolve a tablet, the drug immediately gets into the bloodstream. Within 60-120 seconds should come improvement. An important point - before you put the medication under the tongue, try to sit up, sometimes medication can cause dizziness or even fainting (the elderly). If a person in a very advanced age, then it is better to take the drug at all lying. When the pain in the chest at rest initially take half a tablet if it does not help, then take 3 minutes for a whole tablet sublingually. No improvements - are allowed to take even five minutes tablet. If after 15 minutes the attack had not cropped, it is necessary to urgently call the "First aid"Because it can be a sign of myocardial infarction.
If you are a first time in my life are taking nitroglycerin, first put under the tongue only half a tablet (sometimes in humans is hypersensitivity to this drug).
The dosage form in a spray usedas follows: the patient sits, and then pushes once or twice on the metering valve, injecting the drug under the tongue (or on it). Breathing should be detained, and then immediately close the mouth. Within 15 minutes, you can enter only three doses. Please note that pre-packaging shake is not necessary!
If you have a first aid kit in the capsule, theytake the same manner as sublingual tablets, they only do not divide in halves. If your capsules are red, it indicates that the oil solution within them, such capsules can not be used for emergency removal of an attack, they are only suitable as a prophylactic.
Dosing should be Nitroglycerin solution followsmanner. Please note that 3 drops are equal to one tablet. Therefore, drip 2-3 drops directly on the tongue (or under it), another valid option - under the tongue to dissolve a sugar cube, which dripped a specified dose.
In more severe cases, such as in acute stage of myocardial infarction or pulmonary edema doctors use the drug for intravenous administration.
More than two tablets at one time useimpossible, and the highest daily dose of 6 tablets. If a person is more than the dosage, you can develop a collapse - a condition where blood pressure drops sharply. Then the person turns pale, vomits, weakness is felt.
About side effects and contraindications
Advantages at Nitroglycerin significant. Sometimes it saves people's lives, as antianginal agent emergency. But MirCovetov wants to warn readers that happen and side effects of its reception:
- a sharp decline in pressure, dizziness, fainting up to (in particularly sensitive patients the drug);
- heart palpitations;
- redness, heat sensation, ringing in the ears;
- rarely marked anxiety or, on the contrary, confusion, allergic reactions;
- abdominal pain, nausea.
All these adverse effects can be mitigated orcompletely eliminated, if you take the medication in a sitting position. Recall that the drug should be given to people of advanced age, if possible, when they lie. And only begin treatment with half the dose, to check how an organism responds to the drug. If a person does not tolerate this tool, you can try to combine it with validol. Either use Karniland Votchala or drops, containing not only nitroglycerin, and menthol, tinctures of botanical ingredients - lily of the valley, valerian, belladonna. Patients report that better tolerate such a complex, taking it 10-15 droplets.
And now, our site lists serious contraindications to reception Nitroglycerin:
- myocardial infarction, flowing with a sharp drop in blood pressure;
- brain hemorrhage, hemorrhagic stroke;
- increased intracranial pressure;
- Moved recently head trauma patients;
- collapse, shock;
- toxic pulmonary edema;
- severe anemia;
- hypersensitivity to nitrates;
- gestation period, and when a woman is breast-feeding the baby (reception is permitted only in special cases).
Children under 18 years of age this drug is not prescribed, because there is no data on whether it is in such an early age is safe.
If the patient has a hepatic (or renal) failure, it is necessary to be especially careful when using nitroglycerin.
During treatment should refrain from alcoholic beverages (this is fraught with collapse). In the treatment can not drive vehicles and other mechanisms at work.
It should be remembered that the active substance tabletsrapidly destroyed in the warmth and light. Therefore, it is desirable to store them in a refrigerator. The container and fleece in it are treated with a special solution that can reduce the loss of activity of the active ingredient. Once removed a pill, try to immediately close the vial, so as not to reduce the effectiveness of funds. It is not necessary to remove from the container a few pills and package them in a piece of paper, he says, "on track" when you go for a walk.
If the drug has expired shelf life, it can not be used. Typically, the tablets are stored 2,5, and a droplet spray - 2 years. Keep these products away from children and fire.
Taking the Nitroglycerin, pharmacologists createdmany drugs with sustained action, they are administered to patients for the prevention of angina attacks. The most famous: Nitrosorbid, sustaka, Nitrong, Trinitrolong, Nitrogranulong ...
Scientists continue to search for new tools thatYou could shoot (arrest) angina, but is actively used by the old savior - Nitroglycerin in its various forms. Yet certainly consult a cardiologist, if you suffer from pain in the heart.