Nitrates

Question 1

What is the MOA of organic nitrates

Answer 1

• pro drugs which release NO when metabolised

They increase intracellular Ca

They cause:
• vasodilation
• anti-inflammatory
• inhibits platelet aggregation

^ this is done by stimulating the formation of cGMP (cyclic guanosine monophosphate)

Question 2

ADRs of Organic nitrates

Answer 2

• headache
• postural hypotension
• tachycardia
• flushes
• tolerance

Question 3

Why can Organic Nitrates NOT be taken orally/swallowed

Answer 3

They will be rapidly inactivated by hepatic metabolism

Question 4

Organic nitrates - how to use?

Answer 4

• stop activity
• Use GTN spray or tablets
• Take a second dose after 5 minutes if the pain has not eased.
• Call 999 for an ambulance if the pain has not eased 5 minutes after the second dose

Question 5

How to prevent nitrate tolerance

Answer 5

Nitrate free period

Question 6

Counselling on GTN SL tablets

Answer 6

• keep in original container closed
• keep in cool place, not fridge
• do not keep too close to body warmth
• replace tablets every 8 weeks after opening