The Brand Name GTN PEN Has Generic Salt :: Glyceryl 

GTN PEN  Is From Company Medley Priced :: Rs. 199

GTN PEN have Glyceryl is comes under Sub class #N/A of  Main Class #N/A

Main Medicine Class:: #N/A  Sub Medicine Class :: #N/A 

Indications for Drugs ::

Angina pectoris, Acute myocardial infarction, Severe hypertension, Pulmonary edema.

Drug Dose ::

Usual dosage for adults and elderly patients: PO: 1 capsule/tablet: 2 times a day before meal (e.g. at 8 AM & 2 PM, with a daily nitrate-free interval of 10-12 hours). If necessary the dosage may be raised gradually to 2 or 3 capsules/tablets: 2 times daily. But dosage should be individualized depending on the Nitroglycerin sensitivity of the patient, the severity of illness and the occurrence of side-effects. Use in Children: Not recommended for children. Spray: In case of attack 1 or 2 doses should be administered under the tongue to a sitting patient. If necessary, more doses can be given but not more than 3 doses within 15 minutes. For prevention 1 dose should be applied 5-10 minutes before physical exercise. Use in Children: Nitroglycerin Spray is not recommended for children.

Contraindication ::

Hypersensitivity. Severe hypotension, heart failure, marked anaemia, hypertrophic obstructive cardiomyopathy, cerebral haemorrhage or head trauma, low cardiac output secondary to hypovolaemia, inferior MI with right ventricular involvement, raised intracranial pressure. Concomitant use with phosphodiesterase type-5 inhibitors.

Drug Precautions ::

Severe hepatic or renal impairment, hypothyroidism, malnutrition, hypothermia. Cerebrovascular disease, lung disease or cor pulmonale. Pregnancy, lactation, glaucoma, mitral valve prolapse, cardiac tamponade, syncope. Gradual withdrawal in patients who have received prolonged high dose infusions. Avoid prolonged excessive hypotension. Nitrate-free interval is recommended in patients on continuous treatment with nitrates to reduce risk of tolerance.

Drug Side Effects ::

Headache, facial flashing, dizziness, nausea, vomiting, sweating, palpitation, sensation of heat, postural hypotension and reflex tachycardia. Large doses can cause vomiting, restlessness, hypotension, syncope, rarely cyanosis and methaemoglobinaemia, impaired respiration, bradycardia. Sublingual Tabs/Spray: Dry mouth, localised burning sensation. Buccal tablets: Delayed dissolution, may be swallowed by mistake. Potentially Fatal: Hypotension, paradoxical bradycardia, impaired respiration, syncope and collapse.

Pregnancy category ::

3

Drug Mode of Action ::  

Glyceryl trinitrate acts on the enzyme nitric oxide stimulating guanylate cyclase in the vascular smooth muscle cells resulting in the relaxation of smooth muscles. It reduces venous return (preload) and facilitates subendocardial blood flow with redistribution into ischaemic areas. It relieves coronary vasospasm and dilates arterioles reducing afterload. It is useful for relief and prevention of anginal attacks.

Drug Interactions ::

Enhances bioavailability of dihydroergotamine. Glyceryl trinitrate infusion may prolong pancuronium-induced neuromuscular blockade. May reduce the efficacy of heparin, alteplase and noradrenaline when used together. Efficacy of buccal and sublingual preparations may be reduced by drugs that can cause dry mouth due to decreased dissolution. Aspirin and other NSAIDs may reduce the therapeutic response to glyceryl trinitrate. Potentially Fatal: Orthostatic hypotension may be produced by combined use of calcium channel blockers, antihypertensives, phenothiazines and TCAs. Alcohol may cause severe hypotension and collapse.