Description: Tthis product is Colorless and transparent liquid. Its Main ingredient is isosorbide mononitrate. Its chemical name is 1,4:3,6 - two dehydration-D-sorbitol -5 - Single dinitrate.
Pharmacological effects: Qrganic nitrates release nitric oxide (NO), nitric oxide and endothelial release of relaxing factor, stimulating guanylate cyclase to make cyclic guanosine monophosphate (cGMP) increase while resulting in vasodilation. isosorbide mononitrate is the major active metabolite of isosorbide esters, has a direct relaxant effect on vascular smooth muscle, can cause blood vessels to dilate on the expansion of the vein, thus reducing the Rhodobryum, reducing the heart before loads. Allows the left and elevated right ventricular filling pressure reduces preload in patients with angina pectoris reduced, thereby reducing ventricular diameter and wall tension, reducing myocardial oxygen demand. This product can also be expansion of the arteries, reducing afterload and lead to reduced blood pressure. The product of coronary artery dilatation.
Pharmacokinetics: After intravenous administration, rapidly distributed to the body, with higher levels of the heart, the brain tissue and the pancreas, adipose tissue, skin, colon, adrenal and liver, low levels of plasma protein binding is low. isosorbide mononitrate almost entirely in the liver is metabolized, the denitration almost all metabolites different sorbitol (approximately 37%) and right-handed sorbitol (about 7%) in the form by the kidneys to be excreted in the urine, in addition to 25 grape acid conjugates discharged only about 2% of the drug is excreted unchanged in feces <1%, and its metabolites have no vasodilator. Liver disease does not appear to accumulate phenomenon.
Indications: For the treatment of angina pectoris, chronic heart failure with digitalis and diuretics .
Precautions: Unexuplained pulmonary hypertension (primary pulmonary hypertension) in patients using this service, as a result of the lack of part of the right lung ventilation the relative increase in blood supply, arterial oxygen content can cause a temporary reduction ( hypoxemia), which is particularly seen in the cardiac coronary vascular circulation disorders (CHD) patients. This product can be increased intraocular pressure, glaucoma patients with caution. In the following cases need to be especially careful medical monitoring: aortic stenosis and/or mitral stenosis ,, cycle to patients with adjustment disorder tendency (orthostatic hypotension), diseases associated with intracranial hypertension (so far further increase in pressure was seen only in high doses of intravenous nitroglycerin), with severe renal impairment patients, hypothyroidism, malnutrition and low body weight patients. The product containing 0.9% sodium chloride solution, on the need to limit sodium in patients with caution. To lower blood pressure drugs, antihypertensive drugs, beta-blockers, calcium antagonists, other vasodilators, antipsychotics or tricyclic antidepressants or alcohol may increase the product blood pressure lowering effect. At the same time application of nitrous oxide nitrogen donor, such as the active ingredient in this product and sildenafil (of sildenafil trade name viagra), the antihypertensive effect can be significantly strengthened. It can be used to enhance the the dihydrotestosterone ergotamine liters of blood pressure effect. at the same time taking the alcohols of non-steroidal anti-rheumatic drugs may reduce the effects of this product.
Adverse reaction: Medication early often occurs headache (so-called nitrate-headache), and usually disappear after continued medication a few days. Initial dosing or dose increases, there are often blood pressure to reduce and/or orthostatic hypotension accompanied by reflex pulse rate as well as fatigue, feeling of dizziness, sometimes nausea, vomiting, instant skin redness, fever and allergic skin reaction. In a few cases, can be a serious blood pressure reduction accompanied by angina symptoms add to the (contradiction effect of nitrate) and/or significant contradictions bradycardia. Occasionally reported collapse and syncope (sudden loss of consciousness). may occur in individual cases, exfoliative dermatitis (inflammatory skin disease). Described sustained, long-term use of high-dose 5 - mononitrate isosorbide dinitrate produce cross-resistance of the resistance and other nitro compounds, and should avoid sustained high doses to prevent the weakening or loss of utility. After using this service, hypoventilation relative redistribution of blood flow into the pulmonary vesicles region, there will be transient arterial oxygen. Patients with coronary heart disease may therefore lead to myocardial ischemia.
