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Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant. The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding. The drug is contraindicated in women who are breastfeeding an infant.
Typical usage: Angina pectoris, cardiac failure, cardiopulmonary oedema, long-term treatment of healed reflux oesophagitis, moderate to severe reflux oesophagitis, myocardial infarction, oesophageal spasm, oesophageal spasm, postoperative hypertension, prinzmetal's angina.
Side Effects: Tachycardia, bradycardia, collapse, metabolic acidosis, cardiovascular collapse, syncope, neurologic deficit, methemoglobinemia, weakness, dizziness, headache, nausea, vomiting, restlessness, palpitation, abdominal pain, vertigo, urinary incontinence, syncope, fecal incontinence.
Drug Interaction: Angina pectoris, cardiac failure, cardiopulmonary oedema, long-term treatment of healed reflux oesophagitis, moderate to severe reflux oesophagitis, myocardial infarction, oesophageal spasm, oesophageal spasm, postoperative hypertension, prinzmetal's angina.
Mechanism Of Action: Nitroglycerin is converted to nitric oxide (NO), an active intermediate compound which activates the enzyme guanylate cyclase. This stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) which then activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.