Glyceryl Trinitrate (GTN)
- Oral / Subling / IV / Topical / PatchGlyceryl Trinitrate (GTN)Anginine tablet, Nitrolingual spray, Nitro-Dur PatchVery 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