Description overdue on 04.06.2012

Venodilatiruyuschee means.   The main component is the nitroglycerin group of nitrates. Active substance release nitric oxide, which is an endothelial relaxing factor natural origin. The mechanism of action contributes to the activation of guanylate cyclase. At higher levels of cGMP relaxes smooth muscle fibers of the veins and venules. Nitroglycerin has antispasmodic, antianginal activity , Promotes relaxation of smooth muscles of the digestive tract, Biliary , Vascular walls, ureters .  When administered intravenously, peripheral veins dilate, allowing you to quickly reduce the preload on the heart .  Under the action of nitroglycerin is reduced blood flow to the right atrium, thus reducing the pressure in the pulmonary circulation .  The drug reduces the need for tissue myocardial oxygen reducing afterload, leading to regression of lung edema .  Active ingredient promotes uniform redistribution of coronary blood flow in areas where blood flow is reduced .  .  .  The weakening of the therapeutic effect (tolerance) is developed with frequent, chronic administration of long-acting nitrates .  The sensitivity to the action of the drug is restored after an interruption .  In order to prevent tolerance is necessary to observe the daily "beznitratny interval" during the night, lasting 8-12 hours .  In many patients, this scheme is more efficient than frequent, continual treatment .  Application buccal, sublingual form of the drug can eliminate angina for 1, 5 minutes, and the antianginal, hemodynamic effect   It lasts for 5 hours and 30 minutes, respectively. When using ointments antianginal effects recorded after 15-60 minutes and lasts about 4 hours. Tablet form "retard" can prevent the attack. Nitroglycerin is available in tablet form, as a solution, ointment, metered aerosol, capsules, films, sprays.

Indications:

Sustaka fort used in coronary heart disease, the treatment and prevention of attacks   angina , During rehabilitation of myocardial infarction. Intravenous drug is administered in acute myocardial infarction, pulmonary edema, , Unstable angina, myocardial infarction complicated with left ventricular failure. The drug used in the occlusion of the central retinal artery during surgical interventions for the prevention of major bleeding in the surgical wound.

Contraindications:

Sustaka forte is not applicable while appointing , Intolerant active substance. When intracranial hypertension, hemorrhagic stroke, heart failure with hypotension, acute myocardial infarction with hypotension, glaucoma, hyperthyroidism, severe anemia, hypotension , Severe renal pathology system during pregnancy, liver failure, breastfeeding and people under 18 years of Nitroglycerin used with caution. Oral, long-acting form of the drug is not prescribed for malabsorption syndrome , Increased peristalsis of the digestive tract. Intravenous injections are contraindicated in constrictive pericarditis , Cardiac tamponade, traumatic brain injury, hypovolemia.

Side effect:

Digestive system:   abdominal pain, nausea, dry mouth. Cardiovascular system:   tachycardia, headache, dizziness, fever, redness of the skin, fall in blood pressure, cyanosis, Orthostatic hypotension . Nervous system:   rarely recorded disorientation , Lethargy, psychotic reactions , Anxiety. Also recorded allergic reactions, burning, methemoglobinemia, itching, skin rash, hypothermia, weakness, blurred vision, pin atopic dermatitis .

Overdose:

Manifested   reflex tachycardia , Fall in blood pressure   orthostatic dysregulation , Falling blood pressure, nausea, headaches, fatigue, collapse, vomiting, drowsiness, fever, dyspnea, methaemoglobinaemia , Cyanosis, tachypnea . Vsluchae development of methemoglobinemia administered intravenous infusions of ascorbic acid chloride methylthioninium, hemodialysis, , Exchange transfusion.

Mode of application:

Sustaka Fort administered intravenously, sublingually, dermally, orally, transdermally .  In order to show the relief of angina attack sublingual 0, 5-1 grams .  If necessary, the rapid onset of effect can be crushed capsule teeth .  In patients with stable angina drug effects observed after resorption ½ tablets, in which case it is recommended to spit out the remains .  With the ineffectiveness of the procedure is repeated, after taking 3 tablets need skilled care physician .  If the patient has frequent attacks of angina pectoris, the totem is shown receiving prolonged forms of medication .  Tolerance to sublingual type of drug is extremely rare .  To prevent attack a pill taken orally, washed down with water, preferably the reception - before eating .  Invalid receiving more than 34, 8 grams per day .  Sublingual 1% solution administered in a dose of 1-2 drops sublingually at attacks or drops applied on a sugar cube, and then allowed the patient to complete resorption .  Application buccal forms: the plate is adhered to the mucous wall of the mouth, preferably over small molars, canines in the upper gum .  The plate is pressed against the wall of the mucosa for a few seconds .  Transdermal application: application patches TTS5 1 per day .  On the day of permissible use not more than 1 patch .  .  .  Ointment: 2 is applied on skin, 5 cm of ointment from a tube .  The night is permissible to use no more than 15 cm .  Sublingual nitroglycerin form used for the relief of angina attack: patients need to hold your breath, in a sitting position, click on the dispenser to close for a few seconds .  If necessary, the injection was repeated .

Special instructions:

Sustaka fort in acute Heart Failure , Acute myocardial infarction used only with careful monitoring of the patient .  With a sharp lifting of the drug formulation may be celebrated more frequent angina attacks .  Before performing defibrillation, cardioversion TTS is removed .  It is unacceptable sticking plaster on the hairy scalp .  When methodically properly and individually selected rate of introduction of nitrate were observed undesirable drop in blood pressure .  During the infusion every hour spend control blood pressure levels .  Patients who have taken organic nitrates requires the appointment of high doses of the drug over .  When receiving nitrate possible sharp drop in blood pressure, the appearance of "flies" in front of the eyes .  Severity of headaches during treatment can be reduced by decreasing the dose, the appointment validol .  If dry mouth and blurred vision progresses, the sustaka Fort cancel .  The solutions may contain nitrate that must take into account when treating patients with diabetes mellitus .  Nitroglycerin affects attention, driving transport .

Drug Interactions:

The combined use of beta-blockers, ACE inhibitors , Antihypertensive medications, vasodilators, sildenafil, procainamide, phosphodiesterase inhibitors, monoamine oxidase inhibitors, ethanol   It leads to increased severity of hypotensive effect. Dihydroergotamine is able to increase the drug concentration in the blood, raise the blood pressure. In an application with heparin marked decrease its effectiveness.