Nitroglycerin: A Brief History
Discovered in 1847 by Ascanio Sobrero, nitroglycerin was initially used as an explosive. By the 1870s, doctors noticed its efficacy in alleviating angina pectoris, a symptom of heart disease.
Hospital Use: Chest Pain
In hospitals, nitroglycerin is commonly used to manage acute chest pain. It works by dilating blood vessels, which reduces the heart's oxygen demand and relieves pain.
Administering Nitroglycerin Safely
Nitroglycerin can be given sublingually, topically, or intravenously. Dosages require precision; too much can cause severe hypotension, whereas too little might not alleviate the symptoms.
Nitroglycerin: Beyond Angina Relief
Beyond treating angina, nitroglycerin is also used during heart failure management to reduce cardiac preload and afterload, improving heart function.
Potential Side Effects
Common side effects include headaches, dizziness, and hypotension. Patients should be monitored for blood pressure drops and signs of potential overdose.
Drug Interactions to Avoid
Nitroglycerin can dangerously interact with drugs like PDE5 inhibitors, used for erectile dysfunction. This combination can lead to life-threatening hypotension.
Continuous Use Challenges
Long-term nitroglycerin use can lead to tolerance, necessitating higher doses for the same effect. A nitrate-free period, typically overnight, is recommended to prevent this.