Let's talk about nitrates. Let's look at the names of nitrates. We are prompted by the prefix, with most of the names being or including nit.
The most common ones are nitroglycerin, and the trade names are nitrostat or nitrobed. We also have isosorbide mononitrate, brand name Imadur. Nitrates are vasodilators. Vaso relates to the vessels and dilate means to enlarge or to make bigger. So these medications work to open blood vessels, but how do they do it?
When blood flow is occluded, typically due to something called atherosclerosis. Atherosclerosis is fatty plaque buildup in the vessels. This causes a decrease in blood flow to the heart, which can cause chest pain, also called angina.
Nitrates work to dilate or open up the vessel, which is why they are called vasodilators. This causes an increase in blood flow, decreasing that chest pain or angina. Let's look at the therapeutic uses. Nitrates are used for treatment and prevention of angina, or acute chest pain. This happens when the vessels to the heart become constricted or blocked and the heart doesn't receive enough blood and oxygen.
This causes the patient to have chest pain. It also helps treat acute coronary syndrome. This is sudden blockage of blood flow to the heart that can lead to ischemia. So this medication opens vessels for oxygen and blood to travel through to reach all areas of the body. This allows the patient to perform activities without chest pain.
Let's talk about the must-know side effects of nitrates. You can remember this by the H's of nitrates. We have a headache, hot flushed face, and hypotension.
Since these medications cause the vessels to open up and dilate, the blood is rushing throughout the body and to the head causing these symptoms, a headache and a hot flushed face. We are also opening the vessels which can cause a drop in blood pressure or hypotension. Nitrates are great because they can be given in many routes of administration. The routes that have the quickest onset are the intravenous route or IV route, sublingual tablets, which are tablets placed under the tongue, buckle tablets, which are tablets placed between the cheek and the gums, and oral spray. The routes that have a slower onset are a nitro patch, topical ointment, and sustained released tablets.
Let's look at some patient education for topical or transdermal applications. Prior doses should be removed before applying new doses. The site should be rotated.
The area of placement should be free of hair and clean. And the topical form should not be touched or rubbed into the skin. This can cause rapid absorption and can cause a severe headache. Now for some patient education for sublingual and buccal administration. You do not want to swallow or chew these tablets.
Remember, sublingual should be placed under the tongue and buccal should be placed between the cheek and the gum. You also want to educate your patient that this medication should be kept in its original container. This is usually a dark and glass bottle and it should be stored in a dry, cool place.
The medication should be kept with the patient at all times, just in case they experience chest pain. Okay, let's look at some contraindications for nitrates. Nitrates are contraindicated with the use of something called phosphodirase inhibitors.
These are erectile dysfunction drugs. These are drugs that usually end in the suffix "-afil", like syndelafil, most commonly known as the brand name Viagra. Severe hypotension can occur, resulting in death, if nitrates are taken with this medication.
These medications should also be avoided in patients with increased intracranial pressure, as they can further increase the already elevated ICP. Okay, let's review some of the most commonly tested on information for nitrates. Nitrates work to dilate and open vessels, allowing an increase in blood and oxygen to the brain and body.
It's used for treatment or prevention of angina or acute chest pain. The medication should be kept in its original container, usually a dark glass bottle. Topical nitrates should never be rubbed in or touched as this can result in a severe headache. Phosphodirase inhibitors should not be taken with the use of nitrates due to the risk of extreme hypotension that can result in death. If you want more information like this, you can find it in the complete pharmacology flashcards.
It covers everything you need to know in your pharmacology class, but it's presented in a fun and condensed way, no more textbook fluff. That's all for nitrates. If you found this video helpful, don't forget to subscribe to my YouTube channel. Happy studying, future nurses!