Nitroglycerin, medically also called glyceryl trinitrate, is a nitrate vasodilator used to treat angina, heart attacks and high blood pressure, among other conditions. Although exactly how it works is not entirely settled, it is understood to act as a prodrug that converts to nitric oxide in the body, which activates the enzyme guanylyl cyclase, raises levels of cGMP, and relaxes the smooth muscle of blood vessels. The chemist Ascanio Sobrero first synthesized nitroglycerin in 1846 and noted that handling it caused headaches, an early hint of its vasodilating effect; Constantine Hering developed a medicinal formulation in 1847, and physician William Murrell began treating angina patients with it in 1878, publishing his results in The Lancet in 1879. Physicians adopted the name glyceryl trinitrate in medical use to avoid alarming patients with the compound's better-known identity as an explosive.
Facts
Mechanism of ActionProdrug that is denitrated to produce the active metabolite nitric oxide (NO) 1 Approved UseHeart failure, high blood pressure, anal fissures, painful periods, pain from esophageal spasm, and treating and preventing chest pain (angina) caused by decreased blood flow to the heart or by recreational cocaine use 1 First Approved / Isolated Year Significant RiskSevere hypotension, circulatory collapse and death if used together with vasodilator drugs for erectile dysfunction such as sildenafil, tadalafil and vardenafil 1 Classification
Approval Status ATC ClassSourced to the subject's own accountC: Cardiovascular System 2 Route of Administration Route of Administration WHO Essential Medicine FAQs
Why is nitroglycerin called glyceryl trinitrate in medicine?
Doctors used the name glyceryl trinitrate to avoid alarming patients with the explosive's better-known name.
Physicians adopted the name glyceryl trinitrate, also written trinitrin, so that patients would not be alarmed. Nitroglycerin was widely known as an explosive, and the medical name avoided that association. The substance was first synthesized by the chemist Ascanio Sobrero in 1846, and the physician William Murrell began treating angina patients with small doses in 1878, publishing his results in The Lancet in 1879.
Why is nitroglycerin dangerous to combine with drugs for erectile dysfunction?
Both widen blood vessels; together they can cause severe hypotension and circulatory collapse.
Nitroglycerin relaxes the smooth muscle of blood vessels, and vasodilator drugs used for erectile dysfunction, such as sildenafil, tadalafil and vardenafil, also widen vessels. The sources record that using them together can cause severe hypotension, circulatory collapse and death.
Sources
1. Nitroglycerin (medication) - Wikipedia
Lead section, first sentence (drug class)
also known as glyceryl trinitrate (GTN), is a vasodilator
Article body, sentence beginning 'Nitroglycerin is a prodrug which must be denitrated'
Nitroglycerin is a prodrug which must be denitrated, with the nitrite anion or a related species further reduced to produce the active metabolite nitric oxide (NO).
Lead section, first sentence (medical use)
used for heart failure, high blood pressure, anal fissures, painful periods, treating the pain from esophageal spasm, and to treat and prevent chest pain caused by decreased blood flow to the heart (angina) or due to the recreational use of cocaine
History, sentence beginning 'Murrell began treating patients'
Murrell began treating patients with small doses of nitroglycerin in 1878
Adverse effects, sentence beginning 'Nitroglycerin also can cause severe hypotension'
Nitroglycerin also can cause severe hypotension, circulatory collapse, and death if used together with vasodilator drugs that are used for erectile dysfunction, such as sildenafil, tadalafil, and vardenafil.
Lead section, route-of-administration statement
It is taken by mouth, under the tongue, applied to the skin by cream or a patch, as a spray, or by injection into a vein.
Lead section, route-of-administration statement (topical)
It is taken by mouth, under the tongue, applied to the skin by cream or a patch, as a spray, or by injection into a vein.
- Regulatory approval status
- WHO Model List of Essential Medicines, core list
View the Source2. Anatomical Therapeutic Chemical Classification System (Wikipedia)
WikipediaFirst-level anatomical group codes, Code CQuote, First-level anatomical group codes, Code C
Cardiovascular system
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