Nitroglycerin tablets

Keep nitroglycerin tablets in the original glass container and close the cap tightly after use. 

STE and NSTE ACS, class I recommendation, for patients whose symptoms are not relieved after three serial sublingual nitroglycerin tablets or whose symptoms recur with adequate anti-ischemic therapy. 

Sublingual nitroglycerin, 0.3 to 0.4 mg, relieves pain in about 75% of patients within 3 minutes, with another 15% becoming pain-free in 5 to 15 minutes. Pain persisting beyond 20 to 30 minutes after use of two to three nitroglycerin tablets suggests ACS, and the patient should be instructed to... 

The use of nitroglycerine tablets has been known for several decades to dilate the blood vessels promptly thereby decreasing the blood pressure and thus giving instant relief from angina. However, the present trend is to use other esters of nitric acid such as erythritol tetranitrate, mannitol hexanitrate, PETN and other similar derivatives instead of NG for this purpose. These nitric acid esters being crystalline, are not assimilated readily and therefore, act more slowly but produce a longer lasting effect. 

Pikal, M., and Lukes, A. L. (1976), Kundsen vapor pressure measurements on pure materials and solutions dispersed in porous media Molded nitroglycerin tablets, /. Pharm. Sci., 65,1269. 

Fusari, S. A. (1973), Nitroglycerin subhngual tablets II preparation and stability of a new stabilized subhngual molded nitroglycerin tablet, J. Pharm. Sci., 62, 2012. 

Fung, H.-L., Yap, S. K., and Rhodes, . T. (1974), Development of a stable sublingual nitroglycerin tablet. I. Interaction of nitroglycerin with selected macro-molecules, /. Pharm. Sci., 63,1810. 

Lahiri, A., et al. 1986. Buccal nitroglycerin tablets in heart failure. Ann Intern Med 105 141. 

The oral route is, of course, the principal enteral route of drug administration. However, two other examples are worthy of note. First, the sublingual route (beneath the tongue) provides relatively good absorption because of its rich capillary bed it is routinely used for the administration of nitroglycerin tablets in the treatment of... 

Nitrate therapy should be the first step in managing acute attacks of chronic stable angina if the episodes are infrequent (e.g., a few times per month). If angina occurs no more often than once every few days, then sublingual nitroglycerin tablets or spray or buccal products may be sufficient. 

Waaler, T. Gundersen, H. Kvaleid, L Shangraw, R. The 69. manufacture and evaluation of stabilized nitroglycerin tablets prepared by direct compression. Medd. Nor. Farm. 

Dryness of the mouth may also result in other problems. For example, the tricyclic antidepressant imipramine (e.g., Tofranil) can cause persistent dryness of the mouth. If nitroglycerin tablets are administered sublingually for the management of exertional angina, the relief of the symptoms may be delayed due to the slower dissolution of the sublingual tablets. 

KB is a 59-year-old man who presents to the clinic with unresolved mild chest pain after taking numerous SL nitroglycerin tablets (one every 5 minutes over a total of 30 minutes). He reports that he hasn t used these pills for over a year, but still keeps them by his bedside. He also adds, "Now that I need these pills, they don t work " Which is the most logical reason for the ineffective SL tablets ... 

FIGURE 3 Positive-ion atmospheric pressure chemical ionization mass spectrum at retention time approximately 13.7 minutes for nitroglycerin tablet sample. 

FIGURE 6 HPLC-UV (204 nm) chromatogram (top) and extracted ion chromatogram (m/z 262) using negative ion attachment (Cl-) atmospheric pressure chemical ionization for nitroglycerin tablet. 

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