Nitroglycerin-ZT 0.0005 № 40 tablets
Author Ольга Кияница
|Amount in a package||40|
|Manufacturer||Health Ltd. (Ukraine, Kharkov)|
|The main medicament||Nitroglycerine|
Nitroglycerin-Health, table.0,0005 №40
Code : C01D A02
Vasodilators used in cardiology (C01D)
chemical name: propane-1,2,3-triol trinitrate;
basic physical and chemical properties: white or white tablets with a creamy or grayish shade of color. On the surface of tablets, marble is allowed;
composition: 1 tablet contains nitroglycerin diluted (lactose), recalculated for nitroglycerin 0.0005 g;
auxiliary substances: microcrystalline cellulose, potato starch, low molecular weight medical polyvinylpyrrolidone, aerosil, magnesium stearate, aspartame, crospovidone, milk sugar.
Form of issue.
Vasodilators used in cardiology. Organic nitrates. ATC code C01D A.
Pharmacodynamics. Peripheral vasodilator with a predominant effect on venous vessels. The mechanism of action is associated with the formation of nitric oxide, which activates the guanylate cyclase and increases the content of cGMP in the smooth muscle cells. This leads to nonspecific relaxation of smooth muscle vessels, mainly venous with the deposition of blood in the venous system, a decrease in venous return of blood to the heart (preload) and terminal diastolic filling of the left ventricle. Systemic arterial dilatation, mainly of large vessels, leads to a decrease in the total peripheral vascular resistance (afterload). Due to these effects, myocardial oxygen demand is reduced, cardiac blood flow is improved with its redistribution in favor of ischemic areas. The drug also causes relaxation of the smooth muscles of the bronchi, bile ducts, esophagus, stomach, intestines, genitourinary tract.
Pharmacokinetics. With sublingual use, nitroglycerin is quickly and fairly fully absorbed from the oral mucosa and enters the systemic circulation directly, bypassing the liver. In smooth muscle cells, nitroglycerin is biotransformed to form NO, di- and mononitrate, the final metabolite is glycerol. Binding to plasma proteins is 60%, half-life is 4 hours. It is excreted mainly by kidneys in the form of these metabolites.
With sublingual administration of nitroglycerin, the effect is observed after 1 to 5 minutes and lasts 15 to 30 minutes.
Indications for use. Acute attack of angina pectoris.
Method of administration and dose.
Adults appoint 1 tablet, placing under the tongue until complete resorption. Suppose again taking 2 - 3 tablets for 15 minutes. every
5 minutes. The maximum dose is 6 tablets. The frequency and duration of the drug depends on the frequency, intensity of angina attacks, efficacy and tolerability of therapy.
For the treatment of children, the drug is not used.
Headache, hypotension, reactive tachycardia, reddening of the face, dizziness, nausea, methemoglobinemia. With increased sensitivity to the components of the drug, allergic reactions are possible.
Arterial hypotension (systolic blood pressure below 100 mm Hg, diastolic blood pressure below 60 mm Hg), closed-angle glaucoma with high intraocular pressure, craniocerebral hypertension, severe cerebral arteriosclerosis, hypersensitivity to nitro drugs, severe aortic stenosis .
When the recommended doses are exceeded, headache of varying severity, dizziness, hypotension, increased heart rate, visual impairment, heat and chills, sweating, weakness, nausea, vomiting, dyspnoea, convulsions, orthostatic collapse, coma are possible.
The patient is transferred to a horizontal position (the legs are raised above the head). Treatment is symptomatic (plasma substitutes, sympathomimetics, oxygen).
Features of application.
Applied with caution for the treatment of patients with severe cerebral arteriosclerosis, disorders of cerebral circulation, with a tendency to orthostatic hypotension, severe anemia, in elderly patients. Admission of the drug during pregnancy and during breastfeeding is indicated only in cases when the benefit from its use exceeds the potential risk for the fetus and the baby .. Nitroglycerin can reduce the speed of psychomotor reactions, which should be taken into account when appointing people whose activities require increased attention, fast mental and motor reactions.
Uncontrolled use of the drug causes the development of tolerance to nitrates, which can manifest itself in a decrease in the duration and severity of the effect. To prevent this, intermittent administration during the day or simultaneous administration of calcium antagonists is necessary. Angiotensin converting enzyme inhibitors or diuretics.
Interaction with other drugs.
Simultaneous reception of vasodilators, ACE inhibitors, diuretics, tricyclic antidepressants and MAO inhibitors increases the hypotensive effect of nitroglycerin. The admission of adrenoblockers and calcium channel blockers increases the anti-anginal effect and antihypertensive effect of nitroglycerin. Incompatible with alcohol, since the simultaneous use of alcohol enhances the hypotensive effect and side effects of nitroglycerin. With the simultaneous administration of dihydroergotamine, it is possible to increase its concentration in the blood plasma. The use of nitroglycerin against the background of the action of quinidine or novocaineamide may
cause orthostatic collapse. Contraindicated simultaneous
use with drugs sildenafil citrate (Viagra, etc.) in connection with the possibility of development of orthostatic collapsing.
Conditions and shelf life.
In dry, the dark place at a temperature from
15 С to 25 С. Keep out of reach of children.
Shelf life 2 years.
Terms of leave.
№ 20 in contour cell packings; No. 40 in cans made of glass or plastic containers or plastic containers.