Nitroglycerin
Isn’t it the irony of fate that I have been prescribed nitroglycerin to be taken internally? They call it Trinitrin, so as not to scare the chemist and the public - Alfred Nobel, 1896
image by: Jon Ryberg
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A cardiologist’s advice on how to use this “wonder drug”
The heart drug called nitroglycerin was once described like this in the American Heart Association’s journal Circulation:
“Newer drugs quickly replace older remedies. This has not been the case with nitroglycerin, now in continuous medical use for more than a century. “Although other applications for it have been found in cardiology, nitroglycerin is the mainstay for affording rapid, indeed almost immediate, pain relief for angina pectoris. “At a time when the cost of pharmaceuticals is growing out of reach for many, nitroglycerin is still obtainable for pennies and remains one of the best buys in medicine.”
My little canister of nitro spray is indeed one of my closest…
Resources
Nitroglycerin
Similar to other nitrates used to treat anginal chest pain, nitroglycerin is converted to nitric oxide (NO) in the body. NO then activates the enzyme guanylyl cyclase, which converts guanosine triphosphate (GTP) to guanosine 3',5'-monophosphate (cGMP) in vascular smooth muscle and other tissues.
Nitroglycerin: Major actions and misconceptions
Nitroglycerin or "Nitro" is a commonly encountered medication for EMS, but it may not work the way you think or do what you think it does.
Take nitroglycerin to ease-and avoid-a common heart disease symptom
"My personal view is that these medications are seriously underused. Nitrates have substantial benefits both for chronic stable coronary disease and for heart failure," says Dr. James Januzzi, professor of medicine at Harvard Medical School and director of the cardiac intensive care unit at Massachusetts General Hospital.
The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics
In this review, we detail the discovery of nitroglycerin and its early use in the treatment of angina; the history of the discovery of nitric oxide (NO), its sources, and its roles; the mechanism of action, preparations, and hemodynamic and nonhemodynamic effects of the organic nitrates...
Ask A Scientist: Why isn’t medical GTN spray explosive?
While the tales of medical GTN being explosive are indeed false, it does beg the question: what has caused this assumption to be made, and why isn’t medical GTN explosive?
Mysteries Of Nitroglycerin Solved
While researchers in the past have searched for such an enzyme in different tissues, the Duke team found that the biochemical reaction that breaks down nitroglycerin takes place inmitochondria, a compartment within cells commonly known as the cell's "powerhouse." The enzyme is called mitochondrial aldehyde dehydrogenase (mALDH), and only in mitochondria can the nitric-oxide-related product of the enzyme get further processed to blood vessel-relaxing nitric oxide.
Nitroglycerin Poses Risks to the Heart—but There's an Easy Fix
Though nitroglycerin has been used as a heart medication for over 100 years, scientists have only just recently started looking at it in the lab
Nitroglycerin Use in Myocardial Infarction Patients: Risks and Benefits
GTN is among the most commonly used drugs in the treatment of angina, ischemia and heart failure.4–8 However, there is discussion regarding the deleterious effect of chronic GTN treatment.
Nitroglycerin: Explosive Heart Medication
Imagine a substance so powerful that it could blow you to bits or save your life depending on how you used it. Well imagine no more: such a substance exists and you've probably heard of it.
Physiology of Angina and Its Alleviation With Nitroglycerin
The mechanisms governing exercise-induced angina and its alleviation by the most commonly used antianginal drug, nitroglycerin, are incompletely understood. The purpose of this study was to develop a method by which the effects of antianginal drugs could be evaluated invasively during physiological exercise to gain further understanding of the clinical impact of angina and nitroglycerin.
Three Things To Know About Dynamite, The Reason We Have Nobel Prizes
With all the excitement, it’s easy to forget that there’s a very serious reason we have Nobel Prizes at all — dynamite. Swedish chemist Alfred Nobel made his fortune because he invented dynamite. When he died, he left most of that fortune to establish the prizes that bear his name. So in honor of Nobel Prize week, here are three things you might not know about this infamous explosive.
Viagra and Nitrates: Why These Medications Don't Mix
This drop in blood pressure also occurs with other medications used to treat ED, such as Ciails® (tadalafil) and Levitra® (vardenafil). Other medications that use sildenafil as an active ingredient, such as Revatio®, can also trigger a similar decrease in blood pressure.
A cardiologist’s advice on how to use this “wonder drug”
Nitroglycerin is truly a wonder drug. It dilates coronary arteries and decreases the workload of the heart, two factors responsible for the discomfort. “Yet many anginal patients use the drug only sparingly, if at all."
Nitrostat
NITROSTAT is a stabilized sublingual compressed nitroglycerin tablet that contains 0.3 mg, 0.4 mg , or 0.6 mg nitroglycerin; as well as lactose monohydrate, NF; glyceryl monostearate, NF; pregelatinized starch, NF; calcium stearate, NF powder; and silicon dioxide, colloidal, NF. Nitroglycerin, an organic nitrate, is a vasodilating agent. The chemical name for nitroglycerin is 1, 2, 3 propanetriol trinitrate.
PubChem
Nitroglycerin is an organic nitrate with vasodilator activity. Nitroglycerin is converted into nitric oxide (NO) in smooth muscle and activates guanylyl cyclase, thereby increasing cGMP concentration, and resulting in smooth muscle relaxation. Dilatation of the veins results in decreased venous return to the heart, thereby decreasing left ventricular volume (reduced preload) and decreasing myocardial oxygen requirements. Arteriolar relaxation reduces arteriolar resistance (reduced afterload), thereby decreasing myocardial oxygen demands. In addition, nitroglycerine causes coronary artery dilatation, thereby improving myocardial blood distribution.
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