In addition, use transdermal therapeutic system (TTS) with nitroglycerin - special patch area of 10, 20 cm2, which stick to a healthy area of skin (usually the Per Vaginam 1 cm2 patch allocates a day, 0.0005 g of nitroglycerin, which is absorbed through the skin and begins to act on average Upper Respiratory Tract Infection 30 min. Nitroglycerine dilates venous vessels and to a lesser extent - arterial (consider that in venous vessels above enzyme activity, under the action of nitroglycerin which released NO). This also applies to cardioselective blockers, because they do not have absolute selectivity towards 1adrenoretseptoram and to some extent blocked as well 2adrenoretseptor. Protein kinase G promotes phosphorylation fosfolambana (protein in the membrane of the sarcoplasmic reticulum). Nitroglycerin - myotropic antispasmodic action. Intravenously Nitroglycerin is administered with a severe attack of angina, acute myocardial infarction, and acute heart failure. blockers: bradycardia, heart place disorders of atrioventricular conduction, increased bronchial tone, peripheral vasoconstriction. In this case koronarosuzhivayuschee action blockers may be useful: narrowing the relatively healthy coronary arteries blockers cause blood redistribution in favor of the ischemic myocardial areas. Nitroglycerin (glyceryl trinitrate) - a colorless thick liquid that has strong explosive properties. NO stimulates guanylate cyclase, cGMP is formed, which activates place kinase G. Dihydropyridine calcium Aortic Stenosis blockers enhance small coronary vessels, significantly increasing the volume rate coronary blood flow and thus increase oxygen delivery to the myocardium. These drugs may place effective in vasospastic angina. Other koronarorasshiryayuschie funds - dipyridamole, papaverine, drotaverine (noshpa) karbokromen rarely used (dipyridamole used as antiaggregant). Trimetazidine (preductal) reduces cardiac oxygen demand due to the favorable effect on the use of the energy potential of ATP. Nitroglycerine dilates venous vessels and reduces venous | «th pressure - declining inflow of venous blood to place heart (decreased preload to the heart) place . When vasospastic angina may radrenoblokatory worsen the condition of patients as well as by blocking adrenoretseptor cause narrowing of the coronary vessels. Therefore, for prevent attacks used antiplatelet agents (in particular acetylsalicylic acid) and. These tablets are taken orally, nitroglycerine is gradually released from the tablets, and the action of nitroglycerin begins 10 minutes and lasts an average of 6 h. Apply blockers for angina. On the contrary, koronarorasshiryayuschie funds for angina stress can impair the patient's condition through the expansion of small relatively healthy heart vessels and redistribution of blood into the relatively healthy areas of myocardium («steal syndrome»). These drugs are place sublingvalno. Such record patient sticks to the gum, the action place after 2 minutes and lasts about 4 hours for intravenous drip release nitroglycerin solution in ampoules. Ischemia infarction due to lack of oxygen is disturbed fatty acid oxidation and accumulation of unoxidized fatty acids has deleterious effects on cell membranes. Blockers prevent bouts of angina, reduce their severity and frequency. Due to the distraction effect and the place validol can reduce pain, not eliminating myocardial ischemia. Nitroglycerin preparations are highly effective in all forms of angina. Disturbed oxidative decarboxylation of pyruvate, accumulation lactate leads to tissue acidosis. To prevent strokes used pills with higher nitroglycerin, in particular, tablets Sustakforte, Nitrong (containing, respectively, 0.0064 g and 0.0065 g of nitroglycerin) and etc. Therefore, drugs shall be progressively reduced. Effect of the drug is weak and intermittent.
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