As you know, nitroglycerin is an explosive of enormous destructive power. However, in small doses, it is also a good medicine and in some cases can even save a person’s life. For more than a century, injections with Nitroglycerin solution have been used in emergency cases when the patient’s heart does not cope with its work.
A bit of history
The first ability of nitroglycerin to beneficially affect human health was noticed by the English doctor D. Merill, observing workers engaged in the production of explosives. It was this doctor who subsequently established the fact that nitroglycerin can be used as a medicine designed to eliminate spasms of the heart vessels.
The ability of this remedy to quickly help with angina pectoris was established, thus, it was an experimental way. Actually, the very mechanism of action of nitroglycerin on the human body in the future, unfortunately, has not been studied for a long time. Such studies were carried out by scientists only at the end of the last century.
To date, the drug "Nitroglycerin" is considered one of the most effective means used to quickly help patients with acute attacks of angina pectoris. The analgesic effect when using this medication occurs almost instantly.
Structure
The drug Nitroglycerin can be produced in various forms. In most cases, patients take it in tablets. However, very often this medicine is also supplied to the market in the form of concentrated alcoholic liquid for injection in ampoules of 2-10 ml or bottles of 50-500 ml.
The recipe for the preparation of Nitroglycerin solution is quite simple. Once this drug was produced in very limited quantities. Only a few people could use it for emergency care for heart attacks. Today, this medicine is available in absolutely all pharmacies and clinics. If necessary, purchase this drug at least in tablets will not be difficult.
The main active ingredient of this agent is, of course, nitroglycerin itself. In 1 ml of the drug of this substance contains 10 mg. Also, an additional substance such as ethanol is included in the solution of the Nitroglycerin drug.
How does it affect the patient’s body
The analgesic effect of the use of alcohol solution "Nitroglycerin" occurs in connection with a decrease in myocardial oxygen demand. This happens primarily because of the expansion of veins and a decrease in blood flow to the right atrium. Also, this drug is able to reduce pressure in the pulmonary circulation.
In what cases is assigned
A solution of Nitroglycerin can be used if the patient has problems such as:
In some cases, this tool can also be used in rehabilitation treatment after myocardial infarction.
Side effects
Nitroglycerin helps with heart attacks and angina pectoris very well. However, this remedy, unfortunately, can give a lot. Quite often, for example, after an injection of a Nitroglycerin solution, patients begin to experience a headache. This is due to the expansion of blood vessels in the brain.
Headache in patients after injection of this drug indicates that the medicine has begun to act. In most cases, this side effect is manifested in those people who have not used Nitroglycerin in any form before. Usually this unpleasant phenomenon disappears with time and patients no longer have such a side effect.
Also, when using Nitroglycerin for the treatment of patients, the following may occur:
hyperemia of the skin;
tachycardia;
feeling of heat;
nausea and vomiting;
arterial hypotension.
Sometimes patients after taking this drug begin to experience severe unreasonable anxiety or they develop any other psychotic reactions. In some cases, patients may also be allergic to the components of the drug.
Does the drug have contraindications
Unfortunately, not all people can use the Nitroglycerin injection solution for heart attacks, like any other medicine, unfortunately. First of all, contraindications to the use of this tool may be an allergy to its components. Such reactions are manifested mainly by skin itching and rash. If such symptoms occur, the use of the drug, of course, should be discontinued.
Also contraindications to the use of this tool are:
collapse;
shock;
arterial hypotension;
hypertrophic obstructive cardiomyopathy;
acute heart attack with severe arterial hypotension;
toxic pulmonary edema;
cardiac tamponade;
constrictive pericarditis;
increased intracranial pressure;
intraocular pressure in glaucoma.
In addition, Nitroglycerin is not prescribed for patients with hypersensitivity to nitrates.
Can I use during pregnancy
During the bearing of a child, this drug is allowed. However, the use of this medicine in this case relies solely under the supervision of the attending physician. The same rule should be followed when applying the solution during lactation.
Also, only for health reasons, this drug can be used to provide emergency care to patients:
with epilepsy;
having liver problems;
to children.
In all these cases, the minimum dose of the drug is expected.
In what cases should be taken with caution
Sometimes a doctor has to compare the benefits of using this drug and the possible harm from it. This happens if the patient has, for example, problems such as:
What are the consequences of an overdose?
Take this medicine strictly in accordance with the instructions. Overdoses of the Nitroglycerin solution should not be allowed in any case. Otherwise, the patient may manifest:
tachycardia;
arterial hypotension;
headache;
feeling of heat;
syncope.
In case of an overdose of the Nitroglycerin solution, intracranial pressure also often rises in patients. In this case, the patient may experience confusion and various kinds of neuralgic disorders. Overdosing for several hours leads to ethanol intoxication.
Due to methemoglobinemia, if the Nitroglycerin is used improperly, the patient may develop hypoxia, and subsequently:
cyanosis;
coma;
matabolic acidosis;
cramps
vascular collapse.
Help with overdose
Arterial hypotension in case of an overdose should be eliminated by reducing the speed or completely stopping the administration of the drug. In severe cases, the patient should be placed in a horizontal position. If arterial hypotension is associated with bradycardia, Dopamine and Atropine may also be prescribed to the patient.
With methemoglobinemia, patients are expected to administer a methylene blue solution intravenously. In this case, its dosage should be equal to 1-2 mg per kilogram of body weight.
Instructions for use
Use the solution "Nitroglycerin" only for intravenous injection. With this method of use, the medication acts as quickly as possible. In order to provide emergency assistance to the patient, if necessary, you need to take a solution of "Nitroglycerin" and inject it into a vein using an infusomat or automatic DLV-1. The rhythm of entry into the body and the amount of this medication should be dosed as accurately as possible.
Sometimes this drug can be administered using a conventional system designed for transfusion of fluids. In this case, the exact dose is selected by counting drops per minute. A 0.1% solution of Nitroglycerin is diluted with 5% glucose or sodium chloride (9 parts) to a concentration of 0.01%.
In each case, the selection of the dosage "Nitroglycerin" is carried out by the attending physician individually, depending on:
The initial rate of administration of this agent is usually 0.5-1 mg / h. The maximum is 8-10 mg / h. The duration of administration depends on the condition of the patient and can range from several hours to 3 days.
Interaction with other drugs
The antihypertensive effect of Nitroglycerin, in which the patient has low blood pressure, may increase with the simultaneous administration of:
The use of Nitroglycerin in combination with novocainamide or quinidine can lead to the development of orthostatic collapse in a patient . A medication such as Atropine and drugs that have an M-anticholinergic effect reduce the effect of the use of this agent.
When treating with the use of Nitroglycerin, the patient should definitely refuse to take alcohol. This drug is used in the form of a solution, of course, usually in a hospital setting.
Analogues of the drug
With heart attacks, many people are assisted precisely with the use of the Nitroglycerin solution. In Latin, this drug is called Nitroglycerinum. But of course, if necessary, for the same purpose, you can use some other medicine with a similar effect.
Replace "Nitroglycerin" can, for example, such drugs as:
Nitrocor.
"Wild Long."
"Nitrogranulong."
"Nitrosorbitol."
Means "Nitrokor" and "Nitrogranulong" are synonymous with this medication, because they contain the same active substance. Both of these funds are used in emergency cases to relieve pain in case of heart problems.
The active substance "Nitrosorbite" is isosorbite dinitrate. This medicine is available in the form of tablets and solution. With seizures, only the second option of this drug can be used. Nitrosorbitol tablets act too slowly.
Means “Dikor Long” is not an absolute analogue of “Nitroglycerin”. Use it mainly only for the prevention of attacks. One of the features of this medicine is that it is able to unload the heart muscle. Unfortunately, this medication is acting slowly, and therefore cannot be used in emergency cases.
Drug Reviews
For the most part, people with heart problems, the drug "Nitroglycerin" is praised. Judging by the reviews, he helps with attacks, very well. However, most patients advise taking this medicine only exclusively when it is really necessary. Side effects "Nitroglycerin" actually gives a lot.
Pressure, for example, this medicine can lower to critical limits. Therefore, it is worth using it, and even more so in the form of an alcohol solution intravenously, only with a strong attack. With not too serious heart problems, most patients still advise to relieve pain with the use of lighter drugs, for example, the same Corvalol.
Storage conditions
A feature of Nitroglycerin, among other things, is that it breaks down very quickly in heat and light. Store this drug at home in any form relies only in the refrigerator.
In an opened bottle, this medicine begins to lose its properties very quickly, even in a cool place. In such a capacity, after 2 months its effectiveness will decrease to 30%.
Other forms of release
In addition to tablets and concentrated liquid for injection, this drug can be produced in the form of a spray or an oil solution. "Nitroglycerin" of all these types in any case, judging by the reviews, helps with angina very well.
In the form of an oily solution, this medication is supplied to the market in capsules. Such a form on sale today can be found very often. Of course, if you wish, you can also take the nitroglycerin oil solution in the pharmacy. This form does not help with heart problems as fast as alcohol for injection. However, it, judging by the reviews, can be considered quite effective.
If the patient in the pharmacy decided to take the nitroglycerin oil solution, he, of course, also needs to know how to use it. In this case, the capsule of the medicine in an attack is placed under the tongue. In exactly the same way it is supposed to take tablets of this remedy.
Some people are interested in how to make the nitroglycerin oil solution. The recipe for this medicine is actually quite simple. The drug in this form does not contain any complex components. For example, one of its components is ordinary vegetable oil. However, for a home medicine cabinet, it is worthwhile, of course, to buy ready-made capsules containing such a medicine. Guaranteed to help with a heart attack, of course, can only be an industrial preparation made in compliance with all the required technologies. Experiments in this case can have more than sad consequences.