Nitroglycerin
Nitroglycerin Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring…
Nitroglycerin
Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect.
| Drug | Nitroglycerin |
| Brand names | Gonitro ®, Minitran ®, Mylan-nitro ®, Nitro-bid ®, Nitro-dur ®, Nitroject ®, Nitrolingual ®, Nitromist ®, Nitrostat ®, Rectiv ®, Trinipatch ® |
| Indications | Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension, hypertensive crisis/emergency. Pulmonary hypertension. Blood pressure control. |
| Mechanism of action | Nitroglycerin provides nitric oxide (NO) that induces vasodilatation (of both arterioles and veins) via generation of cyclic GMP, which then activates calcium-sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and pharmacokinetics to nitroprusside, although the latter is more potent. |
| Effects | Antihypertensive. Antianginal. |
| Time to onset of action | 2 to 5 minutes |
| Duration of action | 5 to 10 minutes |
| Delivery | IV |
| Dose | Initial infusion dose: 5 μg/min. Increase by 5-10 μg/min every 5 min to desired blood pressure. Maximum dose: 100 μg/min. Time to onset of action: 2 to 5 minutes Duration of action: 5 to 10 minutes. |
| Adverse effects | Headache (cerebral vasodilation). Tachycardia (due to reflex sympathetic activation). Nausea. Vomiting. Flushing. Palpitations. Tolerance with prolonged use. Methemoglobinemia. Hypoxemia. |
| Caution | Proceed with caution in afterload-dependent conditions. |
Nitroglycerin doses and administration in hypertension (hypertensive crisis/emergency).
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Nitroprusside
Nitroprusside Drug Nitroprusside Brand names Nipride ®, Nipride RTU ®, Nitropress ®. Indications Pulmonary edema, congestive heart failure. Angina pectoris. Hypertension,…