Nitroglycerine drug is a vasodilator .

1. Nitroglycerine
Heena Hassan
Bsc.Nursing 2nd year
190401092

2. Introduction
Nitroglycerin belongs to drug class Nitrates.
It is a Vasodilators ,
Works by relaxing blood vessels.so heart does not
need to work hard,and therefore doesn't need much
oxygen need.
Nitroglycerin is used to treat :
Angina Pectoris.,Heart failure. and MI.

3. Mechanism of Action
Interaction with sulfhydryl (SH-) groups ( nitrate
receptors) inside cells of vascular smooth cells.
Stimulation of formation of endothelial factor of
relaxation of vessels (ERF) _nitrogen oxide (NO)
Decreasing of ionized Ca2+ contents
Relaxation ,dilation of vessels , including
coronary. vessels .

4. Pharmacokinetics
• Rapidly absorbed from the oral mucosa.
• Well absorbed from the gastrointestinal tract and
through the skin.
• Extensive First -pass metabolism.
• Therapeutic effect is apparent within 1 to 3 minutes of
use of sublingual tablets, sprays or buccal tablets.
• Within 30 to 60 minutes of applying an ointment or
transdermal patch .
• Within 1 to 2 minutes after IV doses.

5. Effects
• Relaxes blood vessel walls.
• Dilates coronary arteries.
• Reduces workload of heart.

7. Uses
• Management of Angina Pectoris.
• Heart Failure.
• Myocardial Infraction
• Duration of action 20 to 30 minutes.

8. Administration
Management of Acute Angina
• Nitroglycerine is given as sublingual tablets, a
sublingual aerosol spray ,or buccal tablets.
• These dosage forms may also be used before an
activity or stress which might provoke an attack.
• One sublingual tablet (strength 300 to 600 mg)is
placed under tongue.

9. Treatment of M.I.
• Used intravenously,and to induce hypotension.Or.
Control hypertension during surgery.
• Initial dose =5 to 25 mg /min, adjusted acc.to
response.

10. Treatment of Heart failure.
• Given intravenously =initial dose 5 to 25 mg /min.
• Buccal tablets =in doses of 5 mg repeated until
symptoms are controlled.
• In chronic heart failure =buccal tab.are given 5 to
10 mg three times daily.

11. Adverse effects
• Dizziness
• Tachycardia
• Throbbing headache
• Large doses cause vomiting
• Restlessness
• Blurred vision
• Hypo tension
• Syncope
• Rarlely cyanosis
• Flushing of the face.