Nitroglycerin is not one of the drugs whose main function is to normalize blood pressure (BP). This medicine is intended to relieve spasms of blood vessels in the heart area and prevent angina pectoris. When taking this drug, people with hypertension or hypotension need to know whether nitroglycerin increases or decreases blood pressure.
The effect of Nitroglycerin is observed 1-3 minutes after application. The ability of the drug to expand the lumens of the coronary vessels leads to the relief of an attack of angina and, as a side effect, a rapid decrease in blood pressure.
Nitroglycerin for high blood pressure
The use of the drug prevents the development of:
- stroke;
- myocardial infarction.
Even if pain in the heart occurs, you should take the drug, being careful and starting treatment with a minimum dose of 0.5-1 tablet, 1 sublingual capsule or 1 dose of spray. If drops of Nitroglycerin were found in the patient's medicine cabinet, it is necessary to give 1-2 drops under the tongue or moisten a piece of sugar with 2 drops for resorption.
The short-term effect of the drug allows you to reduce blood pressure until the ambulance arrives and further assistance is provided.
Application of Nitroglycerin:
- The drug should be used in a sitting or lying position due to the risk of dizziness and fainting with a rapid decrease in blood pressure.
- It is necessary to monitor the rate of decrease in blood pressure (with an interval of 10 minutes).
- If after the expected period of time the pressure has not decreased, it is allowed to add a maximum of 1 tablet or 1 dose of spray.
It is worth remembering that Nitroglycerin is not a cure for hypertension.
How to provide first aid during a hypertensive crisis?
- First of all, you should measure your blood pressure and make sure that it is really elevated. In case of extreme indicators, immediately call an ambulance.
Nitroglycerin can be taken during an attack of angina, when high blood pressure causes pain in the chest area
- If blood pressure levels do not exceed 30% of normal working values, you should try to reduce blood pressure using previously prescribed medications, which should be taken by hypertensive patients constantly. Attention! Most of them do not work instantly.
- If, after taking the prescribed medication, blood pressure readings do not decrease, and the patient experiences headache, nausea, vomiting, ringing in the ears, blurred vision, panic, call an ambulance. Do not panic yourself - do not frighten the patient additionally. Blood pressure increases, including as a result of a reaction to fear.
- The patient should be comfortably placed in a reclining position, fresh air should be provided, and tight clothing should be unbuttoned. You can give him Corvalol, Valocordin, motherwort tincture. If the patient is cold, invite him to put his feet in a basin of hot water, this will help reduce blood pressure by dilating peripheral vessels.
Release forms
Nitroglycerin is available in the form:
- sublingual tablets (applied under the tongue) containing 0.0005 g of active substance;
- gelatin-coated capsules containing 0.5 ml or 1 ml of the active substance in the form of an oil solution;
- drops in the form of an alcohol solution with a concentration of 1% (5 or 10 ml);
- spray for sublingual use containing 0.0004 g of active substance in one dose;
- concentrated substance used to prepare an infusion solution in ampoules.
A small dose of the substance can reduce the risk of side effects associated with intolerance to the active component and a sharp decrease in blood pressure levels.
Indications for use
The instructions for use, which are always attached to the drug, clearly state the dosage and application features that are recommended to be observed. If a doctor prescribes a drug, he prescribes the dosage based on the patient’s condition and disease.
Taking pills without consulting a doctor is not recommended. To improve your well-being, you need to drink Nitroglycerin only as prescribed by a cardiologist in case of surges in blood pressure.
To cope with attacks of pain, the tablet is dissolved. The drug should not be swallowed. Dissolve “Nitroglycerin” until completely dissolved in the mouth. Take the drug immediately after the onset of pain. If relief does not occur after 5-10 minutes, you need to take another one.
The spray is also used under the tongue. For one dose, you need to press the valve once so that the spray is sprayed in your mouth. Do not use more than 3 dosages within 15 minutes. If after 3 presses the pain does not go away, then the remedy is ineffective in this case.
Composition and description of nitroglycerin
The composition of Nitroglycerin medicinal products, regardless of the form of release, includes an active substance and auxiliary components that facilitate the penetration of the drug and its removal from the body.
1 tablet of the medication contains:
- active ingredient - nitroglycerin in an amount of 0.0005 g;
- additional components - crospovidone CL; lactose; povidone 25; macrogol 6000.
Depending on the form of release of the drug, the list of auxiliary elements may vary.
Nitroglycerin is used for:
- Coronary heart disease (CHD).
- Acute myocardial infarction.
- Pulmonary edema.
If the use of Nitroglycerin tablets or spray may be sufficient to prevent or relieve an attack, then in more severe cases this is not enough and the drug is used in the form of an infusion. The effect of the medication is directly related to the relaxation of smooth muscle structures, which leads to a decrease in the load on the heart and a rapid decrease in blood pressure.
Nitroglycerin lowers or increases blood pressure • How to cure hypertension
“Nitroglycerin” has a positive effect on blood vessels, eliminating spasms and stopping attacks of angina.
As a fast-acting medication, Nitroglycerin is prescribed for blood pressure - as a result of taking the drug, blood pressure decreases. Many other beneficial properties of this product on the human body have been established.
Let's consider how effective Nitroglycerin is in reducing blood pressure, and how the drug affects the patient's health.
How does Nitroglycerin work?
The beneficial effect of “Nitroglycerin” is achieved due to the active component – glycerol trinitrate, which contains nitrogen. It binds with oxygen to form nitric oxide (NO).
This compound promotes smooth muscle relaxation by activating the production of guanylate cyclase.
This action is accompanied by relieving spasms, reducing the load on the heart, dilating blood vessels, improving blood flow and metabolic processes.
“Nitroglycerin” for high blood pressure helps lower it and has an effect on the body:
- increases the lumen of blood vessels;
- relieves pain in the chest and heart;
- helps eliminate spasm of smooth muscles of the gastrointestinal tract and coronary arteries.
“Nitroglycerin” is contraindicated for low blood pressure, since it achieves the opposite effect.
The substance is often used during attacks of angina pectoris to relieve pain in the chest area
Rules for the use of nitroglycerin for hypertension and hypertensive crisis
During the treatment of high blood pressure, nitroglycerin is taken according to the following rules.
- Since with high blood pressure the active substances of the drug can provoke attacks of dizziness and loss of consciousness, before taking the pill, you should sit down or lie down on the sofa.
- If your heart has not stopped hurting, you can take nitroglycerin again, but no more than 3 tablets at a time.
- For elderly and weakened people with low blood pressure, the dosage should be reduced to 0.5 tablets. Hypotonic patients should agree in advance on the possibility of taking the medication with their treating specialist.
- During treatment with nitroglycerin, alcohol consumption is excluded. Alcohol and the active substance of the drug react and provoke severe intoxication of the body.
- If the medication is taken to prevent angina pectoris before heavy physical work, the tablet should be taken half an hour before exercise.
The most acute manifestation of arterial hypertension and the most dangerous form of the disease is a hypertensive crisis. This attack is accompanied by a sharp rise in pressure.
In such cases, first aid is provided with the help of Valocordin. Nitroglycerin may help relieve symptoms of angina. If the patient cannot open his mouth on his own, the tablet is placed under his tongue or behind his cheek. When using a therapeutic aerosol, it is recommended to spray a stream of active ingredients under the tongue. In this zone, nitroglycerin is better absorbed.
Before giving a patient a nitroglycerin tablet during a hypertensive crisis, you need to make sure that he has already taken this drug before. The first use of the drug can provoke sudden changes in the body, for example, a sudden drop in blood pressure to abnormally low values.
To prevent the medicine from harming the body, you must adhere to the recommended dosages:
- against an attack of angina, it is enough to dissolve from half to two tablets;
- the capsule of the drug contains an average single dose of the active substance;
- in one day the maximum allowable dose is 6 capsules or tablets;
- One click on the aerosol head corresponds to the resorption of one tablet.
A slight violation of the dosage is not dangerous for humans, but a significant excess of the recommended norms can provoke a sharp decrease in blood pressure.
Main types
The drug is quickly absorbed from the skin and surface of mucous membranes. The effect of Nitroglycerin is observed 1-2 minutes after it enters the bloodstream. However, the duration is just as short (up to an hour).
To increase the duration of action of the drug, long-acting agents are used. The active substance (trinitroglycerin) is enclosed in granules, which are then coated. Thanks to this, trinitroglycerin is not released immediately (after 15-20 minutes), but gradually, in parts, which allows you to extend the effect of the drug up to several hours.
Description of the drug
Nitroglycerin was developed to create explosives due to the destructive power it contained based on an exothermic reaction. Today, the use of the substance in question has good intentions - it is an excellent healing agent that allows the myocardium to effectively cope even with excessive loads.
Many practicing doctors actively use the drug Nitroglycerin for hypertension of essential origin - their point of view is based on the hypotensive effect of this drug.
The leading active ingredient is glycerol trinitrate - a substance that, in its structure, is an ester of nitric acid and glycerol, which in itself does not in any way affect the value of blood pressure.
However, when it is broken down, nitrogen dioxide appears, which actually realizes the vasodilating effect.
This feature is in most cases used during attacks of angina pectoris in order to quickly relieve pain localized in the chest area - the so-called cardiogenic pain, cardialgia.
It is advisable to use the pharmaceutical drug to eliminate possible risks of developing an attack of angina, provoked by emotional or physical stress. load.
In addition, for the purpose of prevention, the drug can be taken immediately before going up the stairs or up a mountain, before going outside in unfavorable - windy, frosty weather, and in addition, taking into account the psycho-emotional load, this pharmaceutical should be consumed a few minutes before the beginning of her own public appearance.
Pay attention to the multifactorial effect that Nitroglycerin realizes - this substance not only relieves cardialgia, but also removes soreness of the smooth muscles of the gastrointestinal tract, biliary tract, and also promotes muscular dilatation of the bile duct sphincter. This can justify the relevance of its use during the manifestation of biliary colic, spastic intestinal colitis, and the advisability of use in progressive acute pancreatitis.
Today, the drug in question is produced in the form of tablets, capsules, sprays, drops and ampoules. Moreover, in all the cases listed above, the drug can be classified as a budget drug, because it is produced by domestic factories and, due to its composition, does not require significant costs.
This drug also perfectly exists in the form of liniment, but this form has not gained much popularity.
At the moment, leading pharmacologists are systematically searching for a pharmaceutical drug that would be identical in effectiveness to Nitroglycerin, but devoid of at least some of its disadvantages, because along with its high effectiveness, there are still a huge number of complaints.
Until now, not a single pharmacologist, not a single company, has been able to synthesize, according to the pharmacodynamic mechanism of action, even something remotely similar to nitrates, therefore, when relieving angina, the leading position still clearly remains with Nitroglycerin.
Indications for the use of Nitroglycerin for the heart
“Nitroglycerin” can relieve and prevent vascular spasms of the smooth muscles of the heart for a short time.
Prescribed in the treatment of cardiovascular diseases:
- angina pectoris, to relieve chest pain;
- heart failure;
- hypertensive crisis accompanied by heart pain;
- acute ischemic necrosis;
- neurosurgical operations to artificially lower blood pressure.
In addition, the drug can be used as a prophylaxis to reduce the risk of developing angina caused by stress or physical activity.
Source: https://MedBur.ru/rekomendacii/mozhno-li-nitroglicerin-pri-vysokom-davlenii.html
Contraindications
The use of the drug is contraindicated in the following cases:
- slowing the heart rate to 50 beats per minute;
- hemorrhagic stroke;
- heart failure with normal or low pulmonary artery pressure;
- recent history of brain injury;
- cerebrovascular accidents;
- chronic heart failure with low left ventricular filling pressure;
- individual intolerance to the components of the drug;
- use of phosphodiesterase inhibitors (Sildenafil);
- closed glaucoma;
- intracranial hypertension;
- severe anemia;
- subarachnoid hemorrhage;
- isolated mitral stenosis;
- idiopathic hypertrophic subaortic stenosis;
- cardiac tamponade, constrictive pericarditis, hypovolmia, toxic pulmonary edema, atherosclerosis (with intravenous administration);
- under 18 years of age;
- pregnancy and breastfeeding period.
Before use, you should check the expiration date of the medicine, since after 2 years the effect of the medicine may change significantly.
Nitroglycerin is also used with caution in the following cases:
- thyrotoxicosis;
- arterial hypotension with low systolic blood pressure;
- hypertrophic cardiomyopathy (HCM);
- severe form of renal failure;
- liver failure;
- increased peristalsis of the gastrointestinal tract and malabsorption syndrome (when using prolonged forms of the drug);
- cerebral atherosclerosis;
- tendency to orthostatic hypertension;
- diabetes mellitus;
- over 60 years of age.
Ignoring contraindications or independently changing the dosage of the drug can lead to serious consequences.
Possible side effects
You should not abuse this medicine. People with high blood pressure take Nitroglycerin in courses. Some patients may experience some negative reactions:
- Headache. Since the medicine dilates the blood vessels of the brain, this is fraught with a decrease in intracranial pressure. Therefore, the patient experiences a severe, persistent headache, which goes away after complete elimination of the drug and normalization of the ICP level.
Nitroglycerin tablets instructions for use
- Decreased blood pressure (especially if the patient is in an upright position). When taking Nitroglycerin, it is better to lay the person horizontally or half-sitting.
- Dizziness and fainting. Due to a sharp decrease in blood pressure and ICP, such negative reactions are also possible.
- Nausea and vomiting, abdominal pain.
The most common headache that occurs while taking Nitroglycerin is 60% of patients complain about it. Sometimes allergic skin reactions (itching, rash) are possible.
Side effects and overdose
The use of Nitroglycerin may be accompanied by the following side effects:
- For the cardiovascular system: the appearance of dizziness, headache, tachycardia, skin hyperemia, fever, severe decrease in blood pressure. Also, in case of overdose, cyanosis and orthostatic collapse may develop.
- For the digestive system: nausea, vomiting, abdominal pain, dry mouth.
- For the central nervous system: the appearance in case of overdose of increased anxiety, lethargy or disorientation.
- Manifestation of an allergic reaction: skin rash, itching.
- Signs of blurred vision, weakness, hypothermia, or methemoglobinemia may also occur.
Hypertensive crisis, causes and symptoms
Hypertensive crisis is a sharp increase in blood pressure by more than 30% of its normal, working value. During a hypertensive crisis, first of all, you should try to reduce blood pressure with medications prescribed by a doctor, which should be taken by hypertensive patients constantly.
When a person experiences severe stress or exposes himself to great physical exertion, the body responds with pain in the myocardium, which does not stop for several minutes
It is no secret that many patients with hypertension are not psychologically ready to take prescribed medications for life. After a short course of treatment, and feeling better, they stop taking the pills every day or take them occasionally. The consequence may be a withdrawal syndrome, especially pronounced when stopping β-blockers, Clonidine.
Other possible causes of hypertensive crisis:
- psycho-emotional shock, stress;
- sudden changes in weather conditions, atmospheric pressure;
- abuse of salty foods;
- alcohol abuse (in particular, hangover syndrome);
- kidney diseases;
- release of catecholamines by pheochromocytoma (a hormonally active tumor of the adrenal gland).
A hypertensive crisis is often accompanied by a state of panic, chills, redness and swelling of the face, blurred vision, headache, nausea and vomiting, and tachycardia. In many cases, there is pain in the heart. In complicated cases, pulmonary edema and acute renal failure with a decrease in urine volume may occur.
Interaction
The hypotensive effect of Nitroglycerin is enhanced when used simultaneously with:
- vasodilators;
- antihypertensive drugs;
- angiotensin-converting enzyme (ACE) inhibitors;
- beta-blockers;
- slow calcium channel blockers (SCBC);
- procainamide;
- tricyclic antidepressants;
- monoamine oxidase inhibitors (MAO);
- diuretics.
Also, a strong decrease in blood pressure is accompanied by the simultaneous use of Nitroglycerin with phosphodiesterase inhibitors (Sildenafil).
Possible consequences:
- when used with quinidine and procainamide: orthostatic collapse;
- when used with dihydroergotamine: increased bioavailability of dihydroergotamine and increased blood pressure;
- when used with heparin: decreased effectiveness of heparin.
Combination with various medications can significantly change or enhance the effect of the active substances of the drugs.
Features of Nitroglycerin therapy
If a person is diagnosed with angina pectoris, then Nitroglycerin should always be carried with you. After all, the slightest worries and emotional stress can cause hypertension and chest pain. Your doctor will be able to select the optimal release form for you. It is worth considering that sprays will act faster than regular tablets, but capsules will act more slowly.
After taking the drug, the effect of its use remains for some time. When using prolonged forms of Nitroglycerin, you need to drink them according to the instructions once a day. If you use the usual release form - 0.04 mg tablets, then you will have to drink them every 4-6 hours.
If after taking the medicine the pain in the heart does not decrease and the blood pressure does not decrease, you should consult a doctor.
