Nitrates

Question 1

Nitrates

Answer 1

form the –NO group in the vascular endothelium with the participation of glutathione SH-group

↑ PC (Platelet concentrates) products (vasodilator and antiplatelet effect)
relaxation of all vessels

Question 2

THE MECHANISM OF ANTIANGINAL ACTION OF NITRATES

Answer 2

↓ myocardial consumption of O2

↑ O2 delivery to myocardium

Question 3

IMPROVING THE BLOOD SUPPLY TO THE ISCHEMIC ZONE

Answer 3

• optimizes the function of respiratory enzymes;
• reduces electrical instability of the myocardium and the risk of cardiac arrhythmias;
• breaks the vicious circle of ischemia - pain-ischemia

Question 4

Adverse effects of nitrates

Answer 4

orthostatic hypotension;
reflex tachycardia
increased IOP ( intraocular pressure )
methemoglobin formation;
Paradoxical reaction.
To overcome tolerance:  dose increased (temporary effect)

Question 5

Contraindications

Answer 5

Poor tolerance, allergies
Increased ICP (intracranial pressure), IOP; cerebral hemorrhage;
Shock, hypotension;
Severe anemia;
Myocardial infarction with hypotension.

Question 6

Indications:

Answer 6

• Relief or prevention of attacks of stable and unstable angina pectoris;
• myocardial infarction
• chronic heart failure.

Question 7

Nitrates period

Answer 7

• short action (25-30 min): sublingual tablets, oil solution in capsules
• prolonged action (3-5 hours),
• Used for the relief of strokes

Question 8

For the prevention of attacks used long-acting nitrates

Answer 8

Nitroglycerine (effect more than 10h)
Isosorbide dinitrate (effect 4h)
Isosorbitol 5-mononitrate preparations (8-12 h)