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Glyceryl Trinitrate (GTN)

 
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  •  
    Oral / Subling / IV / Topical / Patch
    Glyceryl Trinitrate (GTN)
    Anginine tablet, Nitrolingual spray, Nitro-Dur Patch 
     
    Very short acting, to be used PRN when symptomatic
  • Mechanism of Action
  • Converted to nitrous oxide which stimulates vascular smooth muscle relaxation through stimulation of cGMP-dependant protein kinase with resultant reduction in intracellular calcium.
  • Results in venous dilatation (reduced preload), arterial dilatation (reduced afterload) and coronary dilatation (improved myocardial oxygen supply)

Clinical Use

  • Indications
  • Stable angina pectoris
  • Acute chest pain
  • Oesophageal spasm
  • Acute hypertension (GTN infusion)
  • Heart failure (GTN infusion) – especially in the setting of hypertension or MI
  • Anal fissure (topical GTN)
  • Adverse Effects
  • Flushing
  • Headache / dizziness
  • Nausea / vomiting
  • Postural hypotension / tachycardia / syncope
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