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 Nitrosorbid
 Vasodilator. It has a peripheral effect on venous vessels. Under the action of the drug reduces the need Nitrosorbide heart muscle oxygen demand. The effect is achieved by reducing the preload . afterload . The drug has koronarorasshiryayuschee action . Nitrosorbid reduces the pressure in the ICC (pulmonary circulation) reduces blood flow to right atrium , Reduces the severity of symptoms of pulmonary edema. Under the action of the drug is a redistribution of blood flow in the region where blood flow is reduced. In patients with coronary artery disease drug increases resistance to physical stress. Nitrosorbide dilates blood vessels in the brain can headaches. Chronic administration says crossed tolerance Nitrate. After a break in the treatment of the body's sensitivity to nitrosorbid recovering fast enough. After receiving tablets nitrate starts to operate after 5 minutes. There are long-acting form of the drug, the effect of which is developing reception in half an hour and lasts for 12 hours. The dosage forms of the drug Nitrosorbid: film gums, metered, sublingual spray, sublingual spray, a tablet form.

Indications:

Nitrosorbid used for the prevention, cupping angina , Myocardial infarction, coronary artery spasm, pulmonary edema, congestive heart failure, angiospastic retinitis . occlusive disease .


Contraindications:

It is not allowed in the intravenous Nitrosorbid intracranial hypertension , Traumatic brain injury (increases in intracranial pressure) constrictive pericarditis . cardiac tamponade . hemorrhagic stroke . hypovolemia . With caution is prescribed for acute myocardial infarction, thyrotoxicosis , Severe anemia, glaucoma, hypotension (accompanied by a low systolic blood pressure), severe renal failure, the system, pregnancy, breastfeeding. Contraindicated in tablet form malabsorption syndrome , Increased bowel motility. Nitrosorbid not applied in paediatrics.

Side effect:

Nervous system : Blurred vision, drowsiness, stiffness, reduced ability to fast motor activity, mental reactions, rarely celebrated   cerebral ischemia . Digestive system : Dry mouth, dyspepsia , Burning tongue, nausea. Cardiovascular system : tachycardia , Drop in blood pressure, flushing of the facial skin, dizziness, feeling of fever, headaches.   Allergic reactions : Rash, itching, redness at the site of application. Other side effects : exfoliative dermatitis . crossed tolerance   other nitrates. In case of overdose observed visual disturbances, palpitations, fainting, dizziness, seizures, hyperthermia, sweating, anoxia, cyanosis . carbohemia , Dyspnea, hyperpnea, coma, paralysis , Bradycardia, increased intracranial pressure. It requires immediate lavage zheluka, which developed methemoglobinemia when administered intravenously 1% solution methylthioninium chloride   at a dosage of 1-2 mg per kilogram. In the fall of blood pressure is injected intravenously Phenylephrine .

Mode of application:

Spray sprayed into the mouth while holding the breath, 1-3 injection every 30 seconds. If no effect within 5 minutes of inhalation should be repeated. Before catheterization for the prevention of coronary spasm is necessary to make 2 inhalation. Tablet form 2, 5-5 mg, if appropriate receiving repeated after 2 hours. Angina is recommended to stop sublingual tablets when chewed vasodilator effect is faster. When the complex treatment chronic heart failure   Nitrosorbide taken 4 times a day, 10-20 mg. Parenteral administration : Intravenously at a rate of 4 drops per minute calculation dosage: 0, 1mg per ml. The maximum permissible rate of introduction - 33 drops per minute. When buccal administration   nitrosorbidom plate adhered to the gums at low molars or incisors, three times daily, alternate sides. Spray   on application to the skin spraying is done at a distance of 20 cm, 2 injection, the contents of rubbing his fingertips. Ointment   applied twice daily at a dose of 1 g on the belly, the inner surface of the forearm, chest area. The minimum area of ​​application is 20 square centimeters.

Special instructions:

During treatment it is recommended regular monitoring of blood pressure, pulse. In acute myocardial infarction, angina attack is recommended to use the forms of sublingual medication or intravenous administration. Long-term use of large doses leads to the formation of tolerance, it is recommended to take breaks. It should completely abandon the alcoholic drinks. In pregnancy, breastfeeding Nitrosorbid appoint only on strict conditions. The drug is effective when toxic pulmonary edema , Congestive heart failure caused by cardiac tamponade. Unacceptable abrupt withdrawal of the drug, a gradual reduction in dose is recommended. Nitrosorbid reduced psychomotor speed, psycho-emotional reactions, requires special care in the management of complex mechanisms driving.

Drug Interactions:

Alpha-blockers . beta-blockers   reduced antianginal effect. Verapamil . nifedipine . propranolol . amiodarone . ascorbic acid   increase antianginal drug. Simultaneous reception antipsychotic . vasodilating . antihypertensive drugs . ethanol , Procainamide, tricyclic antidepressants, sildenafil, quinidine   enhances the hypotensive effect. Enveloping, binding agents, adsorbents   reduce the absorption of isosorbide dinitrate. M-holinoblokatory   in combination with nitrosorbid increase intraocular pressure.