Nitrates adverse reaction

The nitrate antianginal drug all have the same adverse reactions, although the intensify of some reactions may vary with the drug and the dose. A common adverse reaction seen with diese drug is headache, especially early in therapy. Hypotension, dizziness, vertigo, and weakness may also be associated with headache. Flushing caused by dilatation of small capillaries near the surface of the skin may also be seen. 

The nitrates are available in various forms (eg, sublingual, transmucosal, translingual spray, and inhalation). Some adverse reactions are a result of the metiiod of administration. For example, sublingual nitroglycerin may cause a local burning or tingling in the oral cavity. However, die patient must be aware that an absence of this effect does not indicate a decrease in the drug s potency. Contact dermatitis may occur from use of die transdermal delivery system. 

In many instances, the adverse reactions associated with tlie nitrates lessen and often disappear with prolonged use of die drug. However, for some patients, tiiese adverse reactions become severe, and the primary health care provider may lower the dose until symptoms subside The dose may then be slowly increased if the lower dosage does not provide relief from the symptoms of angina... 

Three published controlled trials of the use of vitamin C in treating nitrate tolerance in 77 subjects overall have been reviewed (76). Vitamin C (3-6 g/day orally or by intravenous infusion) reduced nitrate tolerance for up to 3 days, without causing adverse reactions. However, before making definitive recommendations, studies of longer duration should be done in a larger number of patients. 

Despite continuing reports of adverse reactions to withdrawal from chronic occupational exposure to nitrates, there is no clear evidence of similar events in patients taking chronic nitrate therapy. However, since this risk cannot be excluded, patients taking chronic nitrates should be carefully advised and monitored. 

Phenylmercuric acetate is mainly used as an antimicrobial preservative in topical pharmaceutical formulations. A number of adverse reactions to mercury- containing preservatives have been reported see Phenylmercuric Nitrate. 

Control of exudation depends mainly on the suitable choice of the nitrocellulose used. Some lack of uniformity in this product is certainly desirable. This offers no serious difficulty, although it is necessary to ensure a constant watch on manufacturing processes to see that quality is maintained. In other gelatine explosives, particularly those containing ammonium nitrate, exudation can be induced by slow chemical reaction. The addition of alkalis, for example, can liberate ammonia which in turn can react with nitrocellulose and cause it to lose its power of binding nitroglycerine. Such effects are accelerated at high temperatures and under wet conditions and it is usual practice to test all explosives under such adverse conditions before they are put on the market. 

Nitrogen oxides other than nitrogen dioxide have been studied for possible adverse health effects. Chemical analysis of ambient aerosols collected in southern California has revealed that nitrates exhibit particularly high values compared to other parts of the United States. These aerosols are generally acidic in nature and are composed of nitric acid and nitrate salts that are formed through photochemical reactions with nitrogen dioxide and other oxides of... 

Stable Strontium. A single study documented adverse cardiovascular effects in humans resulting from the inhalation of stable strontium in smoke from an ignited roadside flare (Federman and Sachter 1997). Extreme tachycardia resulted as part of an anaphylactic reaction to the smoke, which contained -31% strontium as strontium nitrate, in addition to other known irritants. The role of strontium in this reaction is not established. No other reports were located describing longer-term cardiovascular effects following inhalation of stable strontium compounds by humans or animals. 

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