GENERIC NAME: nitroglycerin, nitroglycerin translingual, nitroglycerin transdermal, nitroglycerin intravenous, nitroglycerin topical
BRAND NAMES: Nitrostat, Nitroquick, Nitrolingual, Nitro-Dur, Minitran, Nitro-Bid and others
DRUG CLASS AND MECHANISM: Nitroglycerin belongs to a class of drugs called nitrates. Other nitrates include isosorbide dinitrate (Isordil) and isosorbide mononitrate (Imdur, Ismo, Monoket). Nitroglycerin is used in the management of angina pectoris (heart pain). Synthesized in 1846, nitroglycerin was first used to treat anginal attacks in 1879. It was granted FDA approval in 1938.
Blood returning from the body in the veins must be pumped by the heart through the lungs and into the arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel"). The production of energy requires oxygen. Angina pectoris (angina) or "heart pain" is due to an inadequate flow of blood (and oxygen) to the muscle of the heart. It is believed that all nitrates, including nitroglycerin, have their effects by dilating (widening) the arteries and veins throughout the body. In patients with angina, nitroglycerin preferentially dilates blood vessels that supply the areas of the heart where there is not enough blood flow and oxygen thereby delivering oxygen to the heart muscle that needs it most. In addition, blood is redistributed to the body within the widened veins, and this reduces the amount of blood returning to the heart that needs to be pumped. Therefore, the heart has less work to do and requires less blood and oxygen. Dilation of the arteries also lowers the pressure in the arteries against which the heart must pump. As a consequence, the heart works even less and requires less blood and oxygen.
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