Angina and Nitrates

Diseases & Conditions Heart & Cardiovascular Disease
1
Nitrates are generally prescribed to aid in preventing angina.
 
When the coronary arteries become constricted, not enough oxygen is able to reach the heart muscle, causing angina (chest pain/discomfort).
 
By taking Nitroglycerin it helps to bring more oxygen to the heart muscle, by relaxing and (widening) dilating the arteries.  Nitrates also help to relax the veins.

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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2

There are different forms of Nitrates.

They can help to prevent an angina attack, limit the amount of attacks that you are having, or actually relieve the pain of an ongoing attack.

There are pill forms that can be swallowed, chewed, dissolved under the tongue (sublingual), ointments placed on the skin, stick on patches and even sprays to be used on or under your tongue.

 

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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3

Sublingual (Under the Tongue) Pills

These can be used at the first sign of an attack of angina, or prior to exercising or activities that may bring on an attack of angina.

Patches

A patch applied to the skin can help to prevent angina attacks.  It's worn for about 12 hours and removed for 12, depending on your Dr.'s orders.

Sprays

As an angina attack begins, you use the spray on or under the tongue - using no more than 3 doses in 15 minutes.  Sprays can be used in advance of exercising or activities that may bring on an attack of angina.

Ointments

The amounts used will depend on your Dr.'s prescribed amount.  It's put on in 'inches'.  You apply it in a thin even layer and like the patches, it's only used for a prescribed amount of time during the day.

Sustained-Release Capsules or Tablets

Usually you would use the smallest effective amount taken 2-3 times a day at 8-12 hours, or as prescribed.

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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4
If you have other health problems it may affect the use of nitro.  Make sure that you physician is aware of the following...
 
Anemia (severe)
Glaucoma—May be worsened by nitroglycerin
Head injury (recent) or
Stroke (recent)—Nitroglycerin may increase pressure in the brain, which can make problems worse
Heart attack (recent)—Nitroglycerin may lower blood pressure, which can aggravate problems associated with heart attack
Kidney disease or
Liver disease—Effects may be increased because of slower removal of nitroglycerin from the body
Overactive thyroid
http://www.drugs.com/cons/nitrates.html

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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5

Please make sure your Dr. is also aware of any of the following medications that you may be taking.  Dosages may need to be adjusted.

Antihypertensives (high blood pressure medicine) or Other heart medicine—May increase the effects of nitroglycerin on blood pressure

Sildenafil (e.g., Viagra) or Tadalafil (e.g., Cialis) or Vardenafil (e.g., Levitra)—These medicines which treat sexual impotence should not be used together with nitrates. You should tell your doctor right away if you are taking one of these drugs.

http://www.drugs.com/cons/nitrates.html

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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6

Here is an excellent link describing chest pain!!

http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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7
Here is an AHA Journal article on nitro (link) that has a little history and how and when to use it. It's been around for a long time!
8
Isosorbide
 
Isosorbide is a nitrate that comes in different forms, including sublingual, or chewable tablets, along with the extended release tabs. 
"Who should not take Isosorbide?  Tell your Dr. if you...
         have had a heart attack;
have congestive heart failure;
have low blood pressure;
have had a stroke, a transient ischemic attack (TIA, or mini-stroke), or a serious head injury;
have anemia;
have an allergy to nitrates;
have closed-angle glaucoma;
suffer from migraines;
have kidney disease; or
have liver disease."
http://www.drugs.com/mtm/isosorbide_dinitrate.html

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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9
Imdur
 
Imdur is another nitrate.
 
"When taken orally and swallowed, nitrates are used to reduce the number of angina attacks that occur. They do not act fast enough to relieve the pain of an angina attack."
http://www.drugs.com/cons/imdur.html

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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10
I sure will be glad to have this discussion!! I'm wearing a .6 mg. Nitro Patch and I'm still taking Nitro sublingually - wonder how high the dosages go?! Will check that out, too. lol

Hugs, Teri :)

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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11
My doctor gave me a perscription for some 0.4 sublingual nitro pills since I kept having pains whenever my heart got pumping to much... Of course now that I have them I`ve only had that pain once...Maybe just knowing I have them handy in my bag makes my heart behave itself :-)
12
Sara, if that does the trick - I am really happy for you!! :)

Hugs, Teri :)

"Because he is he and I am I."......E. V. Lucas

"I Hope You Dance".............LeeAnn Womack
 
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