Nitroglycerine
Nitroglycerine is a medication usually administered to relieve chest pain and angina in cardiac patients. This medication can also be prescribed as needed by a patient’s primary care provider. For acute angina or chest pain the most common form of administration is sublingually which a tablet is placed under the tongue (Hollier, 2019). This administration route is best practice in immediate administration of the drug. Sublingual administration relieves chest pain quicker than the alternate route orally (Kim et al., 2021). The dosing for adults is decided by the patient’s primary care provider and can range from 0.3mg to 0.8mg (Divakaran & Loscalzo, 2017). For sublingual use when symptomatic a patient can place one tablet sublingually every 3 to 5 minutes for a maximum of three tablets (Hollier, 2019).
Bioavailability
Nitroglycerine is available in different forms and can be prescribed based on the patients’ presenting symptoms. Some common forms of the drug include sublingual tablets, sublingual spray, oral forms, topical patches, and oral tablets (Hollier, 2019). One common way nitroglycerine is prescribed is as needed by the patient when experiencing angina at home sublingual. This is a very common form and is absorbed by the body in 1 to 3 minutes and has a bioavailability of around 30% (Divakaran & Loscalzo, 2017). This is a more preferred method as opposed to oral which has a lower bioavailability to the first pass effect. The first pass effect is the reduction of the concentration of the medicine administered due to certain organs in the body such as the liver (Rosenthal & Lehne, 2021).
Conclusion
Nitroglycerine is used to treat Angina in cardiac patients and can be used to lower blood pressure. Primary care providers are responsible for the prescribing and management of care while the patient is taking the medication. Sublingual is the preferred method at home but for instant results IV administration can also be given in an acute setting (Rosethal & Lehne, 2021). The medication effectiveness of the medication depends highly on the route administered. The oral administration greatly reduces the medications effectiveness due to the first pass effect in the body. To avoid the first pass effect the medication is often administered sublingually which dissolvable tablets are given to the patient under their tongue.
References
Hollier, A. (2021). Clinical guidelines in primary care. Advanced Practice Education Associates.
Divakaran, S., & Loscalzo, J. (2017). The Role of Nitroglycerin and Other Nitrogen Oxides in
Cardiovascular Therapeutics. Journal of the American College of Cardiology, 70(19), 2393–2410. https://doi.org/10.1016/j.jacc.2017.09.1064
