Nitroglycerine is a peripheral vasodilator with a predominant effect on venous vessels. Nitroglycerine works by releasing the active substance - nitric oxide in the vascular smooth muscle. Thus substance triggers the activation of guanylate cyclase and increases cGMP, which ultimately leads to smooth muscle relaxation. Due to the influence of nitroglycerin arterioles and precapillary sphincters relax to a lesser extent than the large arteries and veins. The action of nitroglycerin is as well achieved by the decrease in myocardial oxygen demand by decreasing preload and afterload.
This medication is recommended for the treatment of angina, coronary artery spasm during coronary angiography, acute coronary syndrome, acute myocardial infarction, acute left ventricular failure, chronic heart failure. Clinical trials have shown that Nitroglycerine is as well very effective in prevention of hypertensive reactions during endotracheal intubation, skin incisions, occlusion of central artery of the retina and dyskinesia of the esophagus and spastic colon.
Nitroglycerine must not be administered by persons, suffering from hypersensitivity, hypotension, myocardial infarction, infarct of the right ventricle, bradycardia, primary pulmonary hypertension, cerebral hemorrhage, head trauma and increased intracranial pressure. The most frequent side effects include headache, dizziness, weakness, motor restlessness, psychotic reactions, blurred vision and exacerbation of glaucoma.
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