A case of chest pain in the emergency department always go for the protocol of angina and/or MI. The MI protocol primarily focuses on relief of pain with antianginal medications.

What are Antianginal Medications?

Those medicines which reduce the oxygen demand of the myocardium or increases the oxygen supply to the heart are known as The Antianginal Drugs.


Here I will discuss the details of Nitrates




Indications of NITRATES

  • Acute Angina – Prophylaxis and Treatment
  • Chronic Angina treatment
  • Hypertension associated with MI or CHF
  • Raynaud’s disease (NTG ointment)

Mechanism of Action

Antianginals mainly work either by decreasing the Oxygen demand or by increasing oxygen supply.


  • ONSET – 2min (S/L); 3min (PO); 30min (Topical)
  • HALF LIFE – 5-7min
  • METABOLISM – In Liver


  • Sensitivity to Nitrates
  • Severe Anemia
  • Hepatic or Renal dysfunction
  • Hypotension
  • Head Trauma
  • Cerebral Haemorrhage

Side Effects

  • Dizziness (especially at the beginning of the treatment)
  • Orthostatic Hypotension
  • Topical application may lead to dermatitis
  • A throbbing Headache
  • Flushing of face
  • Reflex tachycardia

Drug Interaction

Additive hypotension with other ANTIHYPERTENSIVES

SILDENAFIL (Viagra) can cause additive hypotension

Intake of ALCOHOL along with NTG also cause hypotension


About the nurse’s responsibility, there is a lot to discusses. So I am dealing with it as a separate post. You can read it  NURSING CONSIDERATIONS WHILE ADMINISTERING NITRATES


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