how is nitroglycerin packaged

What is nitroglycerin injection?

How much nitroglycerin is in a bottle?

Why use non-PVC tubing for nitroglycerin injection?

Can nitroglycerin be mixed with heparin?

Does nitroglycerin migrate into plastic?

Does nitroglycerin increase fluid volume?

Can you get allergic to nitrates?

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Why does nitroglycerin come in glass bottles?

Abstract. Nitroglycerin is a volatile substance which evaporates from tablets if strict precautions are not taken. The tablets kept in small, amber, tightly capped glass bottles in a refrigerator maintain their potency for three to five months if bottles are opened once a week.

How is nitroglycerin stored?

Store the sublingual powder at room temperature, away from heat, moisture, and direct light. Sublingual tablets should be kept in the original glass bottle. Screw the cap on tightly after each use and store the bottle at room temperature, away from heat, moisture, and direct light.

Can nitroglycerin be stored in plastic containers?

Nitroglycerin is a product used for angina (i.e., chest pain). Nitroglycerin molecules adhere to plastics; therefore sublingual tablets must be stored in original glass containers under airtight conditions. Failure to maintain proper storage results in loss of drug effect.

How many nitroglycerin tablets come in a bottle?

Nitrostat® (Nitroglycerin Sublingual), 0.4mg, Sublingual, 100 Tablets/Bottle.

Why does nitroglycerin need to be kept in a dark?

The first one that comes to mind is nitroglycerin. People need to keep it in the original bottle, follow storage instructions, and replace it regularly, especially if it's exposed to heat or light, because it can degrade really quickly.

What does nitroglycerin smell like?

Other objects and even some medical conditions are also associated with distinctive odors. For example, the nitroglycerin fumes in dynamite can smell like banana, while food infected with salmonella bacteria can release hydrogen sulfide gas that smells like rotten eggs.

What happens if you take Nitro and you don't need it?

Taking more of this drug than you need can lead to tolerance. This means that, over time, the drug may not work as well to treat your chest pain. Dissolve your dose under your tongue or in your cheek at the first sign of chest pain.

Can you take nitroglycerin on an airplane?

Be sure to request inspection before sending any items through the X-ray tunnel. Airport security also permits nitroglycerin tablets and spray (used to treat episodes of angina in people who have coronary artery disease). Such medications have never been prohibited. (Source: TSA)

Will expired nitroglycerin still work?

Oral nitroglycerin (NTG), a medication used for angina (chest pain), may lose its potency quickly once the bottle is opened and should never be taken after the expiration date. Similarly, insulin, used to control blood sugar in those with diabetes, may stop working after its expiration date.

Does nitrostat need to be dispensed in original container?

Nitroglycerin should be kept in the original glass container and must be tightly capped after each use to prevent loss of tablet potency.

How do you store nitroglycerin sublingual tablets?

Sublingual tablets should be kept in the original glass bottle. Screw the cap on tightly after each use and store the bottle at room temperature, away from heat, moisture, and direct light.

How do you carry nitroglycerin tablets?

Current storage instructions are: Store at controlled room temperature of 20°–25°C (68°–77°F). Nitroglycerin should be kept in the original glass container and must be tightly capped after each use to prevent loss of tablet potency.

What happens when you freeze nitroglycerin?

Early in the history of this explosive it was discovered that liquid nitroglycerin can be "desensitized" by cooling to 5 to 10 °C (40 to 50 °F), at which temperature it freezes, contracting upon solidification.

At what temperature does nitroglycerine explode?

Nitroglycerin is extremely sensitive to shock and to rapid heating; it begins to decompose at 50–60 °C (122–140 °F) and explodes at 218 °C (424 °F).

Why is nitroglycerin so volatile?

It is the speed of the decomposition reaction which makes nitroglycerin such a violent explosive. Unlike burning, which can only travel as fast as the flame front can move through the material, high explosives are decomposed almost instantaneously by a supersonic shock wave passing through the material.

Can nitroglycerin turn into gas?

Detonation of nitroglycerin generates gases that would occupy more than 1,200 times the original volume at ordinary room temperature and pressure.

Nitroglycerin in 5% Dextrose Injection For intravenous use only

The first products in the metabolism of nitroglycerin are inorganic nitrate and the 1,2-and 1,3- dinitroglycerols. The dinitrates are less effective vasodilators than nitroglycerin, but

Nitroglycerin Dosage Guide + Max Dose, Adjustments - Drugs.com

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 4 Oct 2022), Cerner Multum™ (updated 21 Sep 2022), ASHP (updated 12 Sep 2022 ...

Nitroglycerin Injection: Indications, Side Effects, Warnings - Drugs.com

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 4 Oct 2022), Cerner Multum™ (updated 21 Sep 2022), ASHP (updated 12 Sep 2022 ...

NITROGLYCERIN INJECTION,USP - American Regent

for intravenous use only. not for direct intravenous injection. nitroglycerin injection must be diluted in dextrose (5%) injection or sodium chloride (0.9%)

Protocol: Nitroglycerin [NTG] Pharmacology and Actions - UCHealth

DEPARTMENT: Poudre Valley Hospital Emergency Medical Services POLICY DESCRIPTION: Drug Protocol for Nitroglycerin PAGE: 1 of 1 REPLACES POLICY DATED: 4/2011

What is the action of nitroglycerin?

The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle. Although venous effects predominate, nitroglycerin produces, in a dose-related manner, dilation of both arterial and venous beds. Dilation of postcapillary vessels, including large veins, promotes peripheral pooling of blood, decreases venous return to the heart, and reduces left ventricular end-diastolic pressure (preload).

What is the chemical name for nitroglycerin?

Nitroglycerin, an organic nitrate, is a vasodilating agent. The chemical name for nitroglycerin is 1, 2, 3 propanetriol trinitrate and the chemical structure is:

How long does it take for nitroglycerin to work?

Nitroglycerin Sublingual Tablets may be used prophylactically 5 minutes to 10 minutes prior to engaging in activities that might precipitate an acute attack.

What is nitroglycerin sublingual?

Nitroglycerin Sublingual Tablets are indicated for the acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.

What is the effect of nitroglycerin on guanylate cyclase?

These events lead to dephosphorylation of myosin light chains, which regulate the contractile state in smooth muscle, and result in vasodilatation.

How to treat nitroglycerin overdose?

As hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. No specific antagonist to the vasodilator effects of nitroglycerin is known. Keep the patient recumbent in a shock position and comfortably warm. Passive movement of the extremities may aid venous return. Intravenous infusion of normal saline or similar fluid may also be necessary. Administer oxygen and artificial ventilation, if necessary. If methemoglobinemia is present, administration of methylene blue (1% solution), 1-2 mg per kilogram of body weight intravenously, may be required unless the patient is known to have G-6-PD deficiency. If an excessive quantity of nitroglycerin has been recently swallowed gastric lavage may be of use.

How many strengths are in nitroglycerin?

Nitroglycerin Sublingual Tablets, USP are supplied as white, round, flat-faced tablets in three strengths: 0.3 mg (Coded with “V” on one side and “3” on the other) 0.4 mg (Coded with “V” on one side and “4” on the other) 0.6 mg (Coded with “V” on one side and “6” on the other)

How long after nitroglycerin injection can you drive?

Do not drive yourself and call 911, if necessary. You may administer 1 or 2 sprays of Nitroglycerin oral spray at the onset of chest pain. If the pain continues after 5 minutes, a third spray may be used. You must wait 5 minutes after the first 1 or 2 sprays before using a third spray.

How long after taking Nitroglycerin can you spit?

Do not rinse or spit for 5 minutes after taking this medicine. Do not take more than 3 packets in 15 minutes. If you still have pain after you take a total of 3 packets, this is an emergency. Call 911. Do not drive yourself to the hospital. Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed.

How does sublingual spray work?

The oral spray, sublingual powder, and sublingual tablets work quickly to stop an angina attack that has already started or they can be used to prevent angina if you plan to exercise or expect a stressful event.

How to store extended release capsules?

Store the extended-release capsules in a closed container at room temperature, away from heat, moisture, and direct light.

How long after taking a syringe can you take a second syringe?

However, if the pain is not relieved, you may use a second tablet 5 minutes after you take the first tablet. If the pain continues for another 5 minutes , a third tablet may be used. If you still have chest pain after a total of 3 tablets, contact your doctor or go to a hospital emergency room right away.

Can you chew nitroglycerin?

Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth. Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving.

Where was nitroglycerin made?

This amount required at least 336 tonnes of nitroglycerin per week (assuming no losses in production). The Royal Navy had its own factory at the Royal Navy Cordite Factory, Holton Heath, in Dorset, England. A large cordite factory was also built in Canada during World War I. The Canadian Explosives Limited cordite factory at Nobel, Ontario, was designed to produce 1,500,000 lb (680 t) of cordite per month, requiring about 286 tonnes of nitroglycerin per month.

How does nitroglycerin deflagrate?

Nitroglycerin and any diluents can certainly deflagrate (burn). The explosive power of nitroglycerin derives from detonation: energy from the initial decomposition causes a strong pressure wave that detonates the surrounding fuel. This is a self-sustained shock wave that propagates through the explosive medium at 30 times the speed of sound as a near-instantaneous pressure-induced decomposition of the fuel into a white-hot gas. Detonation of nitroglycerin generates gases that would occupy more than 1,200 times the original volume at ordinary room temperature and pressure. The heat liberated raises the temperature to about 5,000 °C (9,000 °F). This is entirely different from deflagration, which depends solely upon available fuel regardless of pressure or shock. The decomposition results in much higher ratio of energy to gas moles released compared to other explosives, making it one of the hottest detonating high explosives .

Why was nitroglycerin banned in California?

In April 1866, three crates of nitroglycerin were shipped to California for the Central Pacific Railroad, which planned to experiment with it as a blasting explosive to expedite the construction of the 1,659-foot-long (506 m) Summit Tunnel through the Sierra Nevada Mountains. One of the crates exploded, destroying a Wells Fargo company office in San Francisco and killing 15 people. This led to a complete ban on the transportation of liquid nitroglycerin in California. The on-site manufacture of nitroglycerin was thus required for the remaining hard-rock drilling and blasting required for the completion of the First Transcontinental Railroad in North America.

What happened to the nitroglycerin wagons?

In June 1869, two one-ton wagons loaded with nitroglycerin, then known locally as Powder-Oil, exploded in the road at the North Wales village of Cwm-y-glo. The explosion led to the loss of six lives, many injuries and much damage to the village. Little trace was found of the two horses. The UK Government was so alarmed at the damage caused and what could have happened in a city location (these two tons were part of a larger load coming from Germany via Liverpool) that they soon passed The Nitro-Glycerine Act of 1869. Liquid nitroglycerin was widely banned elsewhere, as well, and these legal restrictions led to Alfred Nobel and his company's developing dynamite in 1867. This was made by mixing nitroglycerin with diatomaceous earth (" Kieselguhr " in German) found in the Krümmel hills. Similar mixtures, such as "dualine" (1867), "lithofracteur" (1869), and " gelignite " (1875), were formed by mixing nitroglycerin with other inert absorbents, and many combinations were tried by other companies in attempts to get around Nobel's tightly held patents for dynamite.

What was the name of the chemical that was used to make dynamite?

Similar mixtures, such as "dualine" (1867), "lithofracteur" (1869), and " gelignite " (1875), were formed by mixing nitroglycerin with other inert absorbents, and many combinations were tried by other companies in attempts to get around Nobel's tightly held patents for dynamite.

How to desensitize nitroglycerin?

Early in its history, liquid nitroglycerin was found to be " desensitized " by freezing it, at a temperature below 45 to 55 °F (7 to 13 °C) depending on its purity. Its sensitivity to shock while frozen is somewhat unpredictable: "It is more insensitive to the shock from a fulminate cap or a rifle ball when in that condition but on the other hand it appears to be more liable to explode on breaking, crushing, tamping, etc." Frozen nitroglycerine is much less energetic than liquid, and so must be thawed before use. Thawing it out can be extremely sensitizing, especially if impurities are present or the warming is too rapid. Ethylene glycol dinitrate or another polynitrate may be added to lower the melting and thereby avoid the necessity of thawing frozen explosive.

How hot is nitroglycerin?

Early in its history, liquid nitroglycerin was found to be " desensitized " by freezing it, at a temperature below 45 to 55 °F (7 to 13 °C) depending on its purity.

What are the products of nitroglycerin metabolism?

The first products in the metabolism of nitroglycerin are inorganic nitrate and the 1,2- and 1,3-dinitroglycerols. The dinitrates are less effective vasodilators than nitroglycerin, but they are longer-lived in the serum, and their net contribution to the overall effect of chronic nitroglycerin regimens is not known.

What are the side effects of nitroglycerin?

Adverse reactions to nitroglycerin are generally dose-related, and almost all of these reactions are the result of nitroglycerin's activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon.

What is nitroglycerin ointment used for?

INDICATIONS AND USAGE: Nitroglycerin ointment is indicated for the prevention of angina pectoris due to coronary artery disease. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.

How long does it take for nitroglycerin to lose its effectiveness?

Controlled trials with other formulations of nitroglycerin have demonstrated that if plasma levels are maintained continuously, all anti-anginal efficacy is lost within 24 hours. This tolerance cannot be overcome by increasing the dose of nitroglycerin. As a result, any regimen of NITRO-BID ® administration should include a daily nitrate-free interval. The minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient.

How long does nitroglycerin stay in your system?

Pharmacokinetics: The volume of distribution of nitroglycerin is about 3 L/kg, and nitroglycerin is cleared from this volume at extremely rapid rates, with a resulting serum half-life of about three minutes.

What is the formula for nitroglycerin?

Nitroglycerin is 1,2,3-propanetriol trinitrate, an organic nitrate whose structural formula is: and whose molecular weight is 227.09. The organic nitrates are vasodilators, active on both arteries and veins. NITRO-BID ® for topical use contains lactose and 2% nitroglycerin in a base of lanolin, white petrolatum and purified water.

What is methemoglobin color?

Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air.

What is the effect of nitroglycerin on the heart?

The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle. Although venous effects predominate, nitroglycerin produces, in a dose-related manner, dilation of both arterial and venous beds. Dilation of postcapillary vessels, including large veins, promotes peripheral pooling of blood, decreases venous return to the heart, and reduces left ventricular end-diastolic pressure (preload). Nitroglycerin also produces arteriolar relaxation, thereby reducing peripheral vascular resistance and arterial pressure (afterload), and dilates large epicardial coronary arteries; however, the extent to which this latter effect contributes to the relief of exertional angina is unclear.

How long should you take Nitrostat?

If the pain persists after a total of 3 tablets in a 15-minute period, or the pain is different than is typically experienced, prompt medical attention is recommended. Nitrostat may be used prophylactically 5 to 10 minutes prior to engaging in activities which might precipitate an acute attack.

Can you swallow Nitrostat?

Excessive use may lead to the development of tolerance. Nitrostat tablets are intended for sublingual or buccal administration and should not be swallowed.

Can nitrates cause headaches?

Headache which may be severe and persistent may occur immediately after use. Vertigo, dizziness, weakness, palpitation, and other manifestations of postural hypotension may develop occasionally, particularly in erect, immobile patients. Marked sensitivity to the hypotensive effects of nitrates (manifested by nausea, vomiting, weakness, diaphoresis, pallor, and collapse) may occur at therapeutic doses. Syncope due to nitrate vasodilatation has been reported. Flushing, drug rash, and exfoliative dermatitis have been reported in patients receiving nitrate therapy.

What is the mechanism of action of nitroglycerin?

Mechanism of Action: Nitroglycerin forms free radical nitric oxide (NO) which activates guanylate cyclase, resulting in an increase of guanosine 3'5' monophosphate (cyclic GMP) in smooth muscle and other tissues. These events lead to dephosphorylation of myosin light chains, which regulate the contractile state in smooth muscle, and result in vasodilatation.

What is the chemical name for nitroglycerin?

Nitroglycerin, an organic nitrate, is a vasodilating agent. The chemical name for nitroglycerin is 1, 2, 3 propanetriol trinitrate and the chemical structure is:

What is nitroglycerin sublingual?

Nitroglycerin sublingual tablets are indicated for the acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.

How long does it take for nitroglycerin to work?

Effects persist for at least 25 minutes following nitroglycerin administration.

Is nitroglycerin a contraindication?

Sublingual nitroglycerin therapy is contraindicated in patients with early myocardial infarction, severe anemia, increased intracranial pressure, and those with a known hypersensitivity to nitroglycerin.

Does nitroglycerin relax the heart?

The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle. Although venous effects predominate, nitroglycerin produces, in a dose-related manner, dilation of both arterial and venous beds. Dilation of postcapillary vessels, including large veins, promotes peripheral pooling of blood, decreases venous return to the heart, and reduces left ventricular end-diastolic pressure (preload). Nitroglycerin also produces arteriolar relaxation, thereby reducing peripheral vascular resistance and arterial pressure (afterload), and dilates large epicardial coronary arteries; however, the extent to which this latter effect contributes to the relief of exertional angina is unclear.

Can you swallow nitroglycerin?

Excessive use may lead to the development of tolerance. Nitroglycerin sublingual tablets are intended for sublingual or buccal administration and should not be swallowed.

What is nitroglycerin injection?

Nitroglycerin Injection is indicated for treatment of peri-operative hypertension; for control of congestive heart failure in the setting of acute myocardial infarction;for treatment of angina pectoris in patients who have not responded to sublingual nitroglycerin and b-blockers; and for induction of intraoperative hypotension.

How much nitroglycerin is in a bottle?

Aseptically transfer the contents of one nitroglycerin vial (containing 25 mg or 50 mg of nitroglycerin) into a 500 mL glass bottle of either Dextrose (5%) Injection or Sodium Chloride Injection (0.9%). This yields a final concentration of 50 mcg/mL or 100 mcg/mL. Diluting 5 mg nitroglycerin into 100 mL will also yield a final concentration of 50 mcg/mL.

Why use non-PVC tubing for nitroglycerin injection?

Because of the problem of nitroglycerin absorption by polyvinyl chloride (PVC ) tubing, Nitroglycerin Injection should be used with the least absorptive infusion tubing (i.e., non-PVC tubing) available.

Can nitroglycerin be mixed with heparin?

More generally, nitroglycerin in 5% dextrose or so dium chloride 0.9% should not be mixed with any other medication of any kind. Intravenous nitroglycerin interferes, at least in some patients, with the anticoagulant effect of heparin.

Does nitroglycerin migrate into plastic?

Nitroglycerin readily migrates into many plastics, including the polyvinyl chloride (PVC) plastics commonly used for intravenous administration sets. Nitroglycerin absorption by PVC tubing is increased when the tubing is long, the flow rates are low, and the nitroglycerin concentration of the solution is high.

Does nitroglycerin increase fluid volume?

Lower concentrations of nitroglycerin increase the potential precision of dosing, but these concentrations increase the total fluid volume that must be delivered to the patient. Total fluid load may be a dominant consideration in patients with compromised function of the heart, liver, and/or kidneys.

Can you get allergic to nitrates?

Allergic reactions to organic nitrates are extremely rare, but they do occur. Nitroglycerin Injection is contraindicated in patients who are allergic to it. In patients with pericardial tamponade, restrictive cardiomyopathy, or constrictive pericarditis, cardiac output is dependent upon venous return.

Overview

History

Instability and desensitization

Detonation

Manufacturing

Use as an explosive and a propellant

Medical use

Industrial exposure