Glyceryl Trinitrate

Question 1

Class

Answer 1

Vasodilator

Question 2

Classification

Answer 2

Organic Nitrate

Question 3

Actions

Answer 3

Potent Vasodilator of the systemic circulatory system and coronary arteries

Question 4

Indication

Answer 4

• cardiac related chest pain: improves coronary circulation to ischemic areas of the heart through vasodilation (angina and MI)
• acute cardiogenic pulmonary oedema

Question 5

Presentation

Answer 5

• Metered Dose Spray: 400 mcg per dose)

Tablet form

Question 6

Pharmacodynamics

Answer 6

• Potent Vasodilator with reperfusion of tissue easing ischemia.
• increased venous pooling
• reduced venous return (preload)
• onset of action: rapid
• peak effect: 20-30 mins

Question 7

Pharmacodynamic Action

Answer 7

• released Nitric Oxide acts on smooth muscle of vessel wall
• primary action on the systemic venous system (low dose)
• secondary action on coronary artery (higher dose)

Question 8

Pharmacokinetics

Answer 8

• absorption across oral mucosa (spray) into venous system
• high bioavailability when skipping 1st pass metabolism
• metabolised in hepatic system
• excreted through renal system

Question 9

side effects

Answer 9

• hypotension
• tachycardia (compensatory mechanism)
• Headache (cerebral vasodilation)
• Dizziness (decreased CPP)

Question 10

Contra-indications

Answer 10

• Viagra (Silenafil) within 24 hours (- Viagra is a phosphodiesterase (PDE5) inhibitor.
• PDE5 is an enzyme that degrades the effects of organic nitrates thus extending the time of effect.)
• hypotension <90mmHg