As you know, nitroglycerin is an explosive of great destructive power. However, in small doses, it is also a good medicine and in some cases can even save a person's life. Injections with a solution of "Nitroglycerin" have been used for more than a century in emergency cases, when the patient's heart cannot cope with its work.
A bit of history
The first ability of nitroglycerin to have a beneficial effect on human he alth was noticed by the English doctor D. Merrill, while observing the workers involved 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 has been established, thus, has been empirically. 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 angina attacks. The analgesic effect of this medication is almost immediate.
Composition
The drug "Nitroglycerin" can be produced in different forms. In most cases, patients take it in tablets. However, very often this medication is also supplied to the market in the form of an alcoholic concentrated liquid for injection in ampoules of 2-10 ml or vials of 50-500 ml.
The recipe for preparing a solution of "Nitroglycerin" is quite simple. Once upon a time, 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. It will not be difficult to buy this drug if necessary, at least in tablets.
The main active ingredient of this remedy is, of course, nitroglycerin itself. 1 ml of the preparation of this substance contains 10 mg. Also, the composition of the drug solution "Nitroglycerin" includes such an additional substance as ethanol.
How it affects the patient's body
The analgesic effect of the use of an alcohol solution of "Nitroglycerin" occurs due to a decrease in myocardial oxygen demand. This happens primarily due to the expansion of the 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
Nitroglycerin solution can be used if the patient has problems such as:
- myocardial infarction, including with acute left ventricular failure;
- unstable angina;
- pulmonary edema.
In some cases, this remedy can also be used in the rehabilitation treatment after myocardial infarction.
Side effects
Helps "Nitroglycerin" with heart attacks and angina pectoris very well. However, this remedy, unfortunately, can give a lot of side effects. Quite often, for example, after an injection of a solution of "Nitroglycerin" patients begin to experience a headache. It happens because of the expansion of blood vessels in the brain.
Headache in patients after an injection of this drug indicates that the medicine has begun to work. In most cases, this side effect occurs in those people who have not used Nitroglycerin in any form before. Usually, this unpleasant phenomenon disappears with time and such a side effect is no longer observed in patients.
Also, when used for the treatment of Nitroglycerin, patients may experience:
- hyperemia of the skin;
- tachycardia;
- feeling hot;
- nausea and vomiting;
- arterial hypotension.
Sometimes patients after taking this remedy begin to experience strong unreasonable anxietyor they develop some other psychotic reactions. In some cases, patients may also be allergic to the components of the drug.
Does the medicine have contraindications
Unfortunately, not all people can use the Nitroglycerin solution for injections for heart attacks, like any other medicine. First of all, contraindications to the use of this remedy 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 should, of course, be discontinued.
Also contraindications to the use of this remedy are:
- collapse;
- shock;
- arterial hypotension;
- hypretrophic 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 childbearing, taking this drug is allowed. However, the use of this medicine in this case is supposed to be carried out exclusively under the supervision of the attending physician. Same ruleshould be followed when using the solution during lactation.
Also, only for he alth reasons, this drug can be used to provide emergency care to patients:
- with epilepsy;
- having liver problems;
- children.
In all of these cases, the minimum dose of medication is supposed to be used.
When should I take it with caution
Sometimes the doctor has to balance the benefits of using this drug and the possible harm from it. This happens if the patient has, for example, such problems as:
- constrictive pericarditis;
- severe anemia;
- cardiac tamponade;
- atherosclerosis;
- recent head injury;
- brain hemorrhage;
- severe kidney failure;
- acute infarction with low left ventricular filling pressure;
- liver disease;
- thyrotoxicosis.
What are the consequences of an overdose
This medicine should be taken strictly according to the instructions. Overdoses of the "Nitroglycerin" solution should not be allowed in any case. Otherwise, the patient may manifest:
- tachycardia;
- arterial hypotension;
- headache;
- feeling hot;
- syncope.
In case of an overdose of Nitroglycerin solution, patients also often have a strong increase in intracranial pressure. In this case, the patient may experience confusion and various kinds of neuralgic disorders. An overdose within a few hours leads to ethanol intoxication.
Due to methemoglobinemia, if "Nitroglycerin" is used incorrectly, the patient may develop hypoxia, and subsequently:
- cyanosis;
- coma;
- metabolic acidosis;
- convulsions;
- vascular collapse.
Overdose help
Arterial hypotension in case of overdose should be eliminated by reducing the rate or even 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, the patient may also be prescribed drugs "Dopamine" and "Atropine".
Methemoglobinemia patients are supposed to inject methylene blue solution intravenously. Its dosage should be equal to 1-2 mg per kilogram of body weight.
Instructions for use
Use a solution of "Nitroglycerin" only for intravenous injections. With this method of application, the drug 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 infusion pump or automatic DLV-1. Dosed rhythmintake and amount of this medicine should be as accurate as possible.
Sometimes this drug can also be given using a regular system designed for transfusion of fluids. In this case, the choice of the exact dose is made 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 of "Nitroglycerin" is carried out by the attending physician on an individual basis, depending on:
- blood pressure;
- ECG;
- venous pressure;
- heart rate.
The initial rate of administration of this agent is usually 0.5-1 mg/h. The maximum in this case 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 hypotensive effect of "Nitroglycerin", in which the patient has low blood pressure, may increase with simultaneous administration:
- morphine and other vasodilators;
- ACE inhibitors;
- beta-blockers;
- neuroleptics;
- Viagra;
- diuretics;
- tricyclic antidepressants;
- analgesics;
- ethanol.
The use of "Nitroglycerin" in combination with novocainamide or quinidine can lead to the development of orthostatic collapse in the patient. Reduce the effect of the use of this drug such a medication as "Atropine" and drugs that have an M-anticholinergic effect.
When treating with Nitroglycerin, the patient should definitely stop drinking alcohol. This drug is used in the form of a solution, of course, usually in a hospital setting.
Medicine analogues
With heart attacks, many people are helped with the use of the Nitroglycerin solution. In Latin, this drug is called Nitroglycerinum. But of course, if necessary, some other medicine with a similar effect can be used for the same purpose.
You can replace Nitroglycerin, for example, with drugs such as:
- Nitrocore.
- Dikor Long.
- "Nitrogranulong".
- "Nitrosorbite".
Means "Nitrocor" and "Nitrogranulong" are synonymous with this medication, because they contain the same active ingredient. Both of these remedies are used in emergency cases to relieve pain in case of heart problems.
The active ingredient of Nitrosorbit is isosorbite dinitrate. This medicine is available in the form of tablets and solution. For seizures, only the second version of this drug can be used. "Nitrosorbit" in tabletsacting too slowly.
Means "Dikor Long" is not an absolute analogue of "Nitroglycerin". It is mainly used for the prevention of seizures. One of the features of this drug is that it is able to unload the heart muscle. Unfortunately, this medication works slowly, and therefore cannot be used in emergency cases.
Drug reviews
For the most part, people with heart problems praise Nitroglycerin. It helps with seizures, judging by the reviews, very well. However, most patients advise taking this medicine only 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 is very quickly destroyed in heat and in the light. Keep this drug at home in any form only in the refrigerator.
In an opened vial, this medicine begins to lose its properties very quickly even in a cool place. In such a container, its efficiency will drop to 30% in 2 months.
Other shapesrelease
In addition to tablets and concentrated liquid for injection, this drug is available in the form of a spray or oil solution. "Nitroglycerin" of all these types, in any case, judging by the reviews, helps with angina pectoris very well.
As an oily solution, this medicine is marketed in capsules. This form of it on sale today can be found very often. Of course, if you wish, you can also take an oil solution of Nitroglycerin in a pharmacy. Helps with heart problems, this form is not as fast as an alcohol injection. However, judging by the reviews, it can be considered quite effective.
If a patient in a pharmacy decides to take an oil solution of "Nitroglycerin", he, of course, also needs to know how to use it. In this case, a medicine capsule is placed under the tongue during an attack. The tablets of this remedy are supposed to be taken in exactly the same way.
Some people are also interested in how to make an oil solution of Nitroglycerin. 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 first aid kit, it is worth buying, of course, ready-made capsules containing such a medicine. Guaranteed to help with a heart attack, of course, can only be an industrial drug manufactured in compliance with all the required technologies. Experiments in this case may havethe consequences are more than sad.
