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cost flexible explosive medical use edit main article medical use of nitroglycerin nitroglycerin in three different forms intravenous sublingual spray and the nitroglycerin patch nitroglycerin belongs to a group of drugs called nitrates which includes many other nitrates like isosorbide dinitrate isordil and isosorbide mononitrate imdur ismo monoket 35 these agents all exert their effect by being converted to nitric oxide in the body by mitochondrial aldehyde dehydrogenase aldh2 8 and nitric oxide is a potent natural vasodilator in medicine nitroglycerin is probably most commonly prescribed for angina pectoris a painful symptom of ischemic heart disease caused by inadequate flow of blood and oxygen to the heart and as a potent antihypertensive agent nitroglycerin corrects the imbalance between the flow of oxygen and blood to the heart and the heart s energy demand 35 there are many formulations on the market at different doses at low doses nitroglycerin dilates veins more than arteries thereby reducing preload volume of blood in the heart after filling this is thought to be its primary mechanism of action by decreasing preload the heart has less blood to pump which decreases oxygen requirement since the heart does not have to work as hard additionally having a smaller preload reduces the ventricular transmural pressure pressure exerted on the walls of the heart which decreases the compression of heart arteries to allow more blood to flow through the heart at higher doses it also dilates arteries thereby reducing afterload decreasing the pressure against which the heart must pump 35 an improved ratio of myocardial oxygen demand to supply leads to the following therapeutic effects during episodes of angina pectoris subsiding of chest pain decrease of blood pressure increase of heart rate and orthostatic hypotension patients experiencing angina when doing certain physical activities can often prevent symptoms by taking nitroglycerin 5 to 10 minutes before the activity overdoses may generate methemoglobinemia 36 37 nitroglycerin is available in tablets ointment solution for intravenous use transdermal patches or sprays administered sublingually some forms of nitroglycerin last much longer in the body than others nitroglycerin as well as the onset and duration of action of each form is different the sublingual or tablet spray of nitroglycerin has a two minute onset and a twenty five minute duration of action the oral formulation of nitroglycerin has a thirty five minute onset and a duration of action of 4 8 hours the transdermal patch has an onset of thirty minutes and a duration of action of ten to twelve hours continuous exposure to nitrates has been shown to cause the body to stop responding normally to this medicine experts recommend that the patches be removed at night allowing the body a few hours to restore its responsiveness to nitrates shorter acting preparations of nitroglycerin can be used several times a day with less risk of developing tolerance 38 nitroglycerin was first used by william murrell to treat angina attacks in 1878 with the discovery published that same year 18 39 industrial exposure edit infrequent exposure to high doses of nitroglycerin can cause severe headaches known as ng head or bang head these headaches can be severe enough to incapacitate some people however humans develop a tolerance to and dependence on nitroglycerin after long term exposure although rare withdrawal can be fatal 40 symptoms include chest pain and other heart problems these symptoms may be relieved with re exposure to nitroglycerin or other suitable organic nitrates 41 for workers in nitroglycerin ntg manufacturing facilities the effects of withdrawal sometimes include sunday heart attacks in those experiencing regular nitroglycerin exposure in the workplace leading to the development of tolerance for the venodilating effects over the weekend the workers lost their tolerance and when they were re exposed on monday the drastic vasodilation produced a fast heart rate dizziness and a headache this is referred to as monday disease 42 43 people can be exposed to nitroglycerin in the workplace by breathing it in skin absorption swallowing it or eye contact the occupational safety and health administration has set the legal limit permissible exposure limit for nitroglycerin exposure in the workplace as 0 2 ppm 2 mg m 3 skin exposure over an 8 hour workday the national institute for occupational safety and health has set a recommended exposure limit of 0 1 mg m 3 skin exposure over an 8 hour workday at levels of 75 mg m 3 nitroglycerin is immediately dangerous to life and health 44 see also edit erythritol tetranitrate ethylene glycol dinitrate mannitol hexanitrate methyl nitrate relative effectiveness factor tetranitratoxycarbon xylitol pentanitrate references edit 1 2 occupational safety and health guideline for nitroglycerin archived from the original on 16 may 2013 retrieved 19 october 2016 niosh pocket guide to chemical hazards 0456 national institute for occupational safety and health niosh hazard rating information for nfpa fire diamonds archived from the original on 17 february 2015 ascanio sobrero oxford reference retrieved 16 july 2024 1 2 3 occupational safety and health guideline for nitroglycerin 16 may 2013 archived from the original on 16 may 2013 retrieved 9 july 2024 haynes w m crc handbook of chemistry and physics 97th ed crc press pp 3 540 nitroglycerin desensitized liquid cameo chemicals noaa archived from the original on 26 august 2023 retrieved 9 july 2024 1 2 chen z foster m w zhang j mao l rockman h a kawamoto t kitagawa k nakayama k i hess d t stamler j s 2005 an essential role for mitochondrial aldehyde dehydrogenase in nitroglycerin bioactivation proceedings of the national academy of sciences 102 34 12159 12164 bibcode 2005pnas 10212159c doi 10 1073 pnas 0503723102 pmc 1189320 pmid 16103363 unknown behind paywall archived archived from the original on 10 may 2017 retrieved 14 april 2018 sobrero ascagne 1847 sur plusieur composés détonants produits avec l acide nitrique et le sucre la dextrine la lactine la mannite et la glycérine on several detonating compounds produced with nitric acid and sugar dextrin lactose mannitol and glycerin comptes rendus 24 247 248 whose translation sobrero ascanio 1849 sopra alcuni nuovi composti fulminanti ottenuti col mezzo dell azione dell acido nitrico sulle sostante organiche vegetali on some new explosive products obtained by the action of nitric acid on some vegetable organic substances memorie della reale accademia delle scienze di torino 2nd series 10 195 201 on p 197 sobrero names nitroglycerin pyroglycerine quelle gocciole costituiscono il corpo nuovo di cui descriverò ora le proprietà e che chiamerò piroglicerina those drops constitute the new substance whose properties i will now describe and which i will call pyroglycerine whose translation emil nobel nobelprize org archived from the original on 15 january 2009 retrieved 6 october 2008 ramsay sir william 28 december 1907 the manufacture of high explosives scientific american springer nature retrieved 4 march 2024 krümmel nobelprize org archived from the original on 10 july 2006 transcontinental railroad people events nitroglycerin american experience pbs 1 2 crump eryl 14 october 2018 the deadly explosion that killed six and whose impact reverberated across the uk murrell william 1879 nitroglycerin as a remedy for angina pectoris the lancet 1 2890 80 81 113 115 151 152 225 227 doi 10 1016 s0140 6736 02 46032 1 pmc 5901592 1 2 sneader walter 2005 drug discovery a history john wiley and sons isbn 978 0 471 89980 8 history of tng beyonddiscovery org archived from the original on 1 november 2010 retrieved 14 april 2018 is nitroglycerine in this page 5 www logwell com retrieved 20 february 2024 hurter charles s 22 august 1911 accidents in the transportation storage and use of explosives pdf proceedings of the lake superior mining 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interactions drug metabolism reviews 4 1 1 38 doi 10 3109 03602537508993747 pmid 812687 lewis richard j sr 15 march 2007 hawley s condensed chemical dictionary 15th ed united states john wiley sons inc p 897 isbn 978 0 471 76865 4 cite book cs1 maint multiple names authors list link wexler philip 7 april 2014 encyclopedia of toxicology 3rd ed usa academic press p 569 isbn 978 0123864543 bellis mary alfred nobel and the history of dynamite about com money archived from the original on 28 august 2021 retrieved 10 november 2009 miller j s johansen r t 1976 fracturing oil shale with explosives for in situ recovery pdf shale oil tar sand and related fuel sources 151 bibcode 1976sots rept 98m archived from the original pdf on 2 october 2018 retrieved 27 march 2015 nitroglycerin 1 2 3 ogbru omudhome nitroglycerin nitro bid drug facts side effects and dosing medicinenet kaplan k j taber m teagarden j r parker m davison r 1985 association of methemoglobinemia and intravenous nitroglycerin administration american journal of cardiology 55 1 181 183 doi 10 1016 0002 9149 85 90324 8 pmid 3917597 intramed bienvenido www intramed net retrieved 14 april 2018 nitroglycerin for angina february 1997 vol 7 archived from the original on 10 may 2017 retrieved 9 november 2009 smith e hart f d 1971 william murrell physician and practical therapist british medical journal 3 5775 632 633 doi 10 1136 bmj 3 5775 632 pmc 1798737 pmid 4998847 amdur mary o doull john 1991 casarett and doull s toxicology 4th ed elsevier isbn 978 0071052399 sullivan john b jr krieger gary r 2001 clinical environmental health and toxic exposures latex lippincott williams wilkins p 264 isbn 978 0 683 08027 8 retrieved 23 april 2013 marsh n marsh a 2000 a short history of nitroglycerine and nitric oxide in pharmacology and physiology clinical and experimental pharmacology and physiology 27 4 313 319 doi 10 1046 j 1440 1681 2000 03240 x pmid 10779131 s2cid 12897126 assembly of life sciences u s advisory center on toxicology toxicological reports national academies p 115 nap 11288 retrieved 23 april 2013 nitroglycerine niosh pocket guide to chemical hazards cdc retrieved 21 november 2015 external links edit wikimedia commons has media related to nitroglycerin nitroglycerine terrible explosion and loss of lives in san francisco central pacific railroad photographic history museum retrieved 23 march 2005 1866 newspaper article webbook page for c 3 h 5 n 3 o 9 cdc niosh pocket guide to chemical hazards the tallini tales of destruction archived 19 july 2012 at the wayback machine detailed and horrific stories of the historical use of nitroglycerin filled torpedoes to restart petroleum wells dynamite and tnt at the periodic table of videos university of nottingham v t e nitric oxide signaling modulators forms nitroxyl anion no oxonitrate 1 hyponitrite anion nitric oxide no nitrogen monoxide nitrosonium no nitrosyl cation targets sgc activators stimulators ataciguat avenciguat bay 41 2272 bay 41 8543 bay 60 4552 bi 703704 cinaciguat bay 58 2667 cy 3018 frespaciguat gsk 2181236a olinciguat praliciguat riociguat vericiguat zagociguat inhibitors odq no donors prodrugs nitrates diethylene glycol dinitrate degdn erythritol tetranitrate etn ethylene glycol dinitrate egdn nitroglycol isosorbide mononitrate ismn isosorbide dinitrate isdn itramin tosilate mannitol hexanitrate naproxcinod nitronaproxen azd 3582 hct 3012 ncx 466 ncx 2216 ncx 4016 ncx 4040 ncx 4215 nicorandil nipradilol k 351 nitrate no 3 nitroatorvastatin ncx 6560 nitroflurbiprofen hct 1026 nitrofluvastatin nitroglycerin glyceryl trinitrate gtn nitropravastatin ncx 6550 pentaerithrityl tetranitrate petn propatylnitrate propylene glycol dinitrate pgdn sodium trioxodinitrate angeli s salt tenitramine trolnitrate nitroso compounds nitrites nitrite no 2 o nitroso compounds alkyl nitrites amyl nitrite isoamyl nitrite isopentyl nitrite cyclohexyl nitrite ethyl nitrite hexyl nitrite isobutyl nitrite 2 methylpropyl nitrite isopropyl nitrite methyl nitrite n butyl nitrite pentyl nitrite tert butyl nitrite s nitroso compounds thionitrites la810 s nitrosoalbumin snalb s nitrosated ar545c s nitroso n acetylcysteine snac s nitroso n acetylpenicillamine snap s nitroso n valerylpenicillamine snvp s nitrosocaptopril sno cap s nitrosocysteine snc cysno sno cys s nitrosodiclofenac s nitrosoglutathione gsno snog sno t pa sno vwf n nitroso compounds e g nitrosamines sin 1a nitrosyl compounds metal nitrosyl complexes roussin s black salt roussin s red salt sodium nitroprusside snp nonoates diazeniumdiolates diethylamine no dea no diethylenetriamine no deta no glo no js k methylamine hexamethylene methylamine no mahma no proli no spermine no sper no v pyrro no heterocyclic compounds furoxans furoxan rec15 2739 sydnonimines feprosidnine linsidomine sin 1 molsidomine sin 10 sydnonimine unsorted cimlanod fk 409 fr144220 fr146881 n acetyl n acetoxy 4 chlorobenzenesulfonamide enzyme inhibitors nos nnos 3 bromo 7 nitroindazole 3 chloroindazole 3 chloro 5 nitroindazole 5 nitroindazole 6 nitroindazole 7 nitroindazole a 84643 aminoguanidine pimagedine arl 17477 indazole n 5 1 iminoethyl l ornithine l nio n ω methyl l arginine l nma n ω propyl l arginine l npa nitroarginine nna noarg pentamidine isethionate trim inos 1 amino 2 hydroxyguanidine 2 ethylaminoguanidine 2 iminopiperidine 1400w aeitu aminoguanidine pimagedine amt ar c 102222 byk 191023 canavanine cindunistat sd 6010 eitu iptu mitu n 5 1 iminoethyl l ornithine l nio n 6 1 iminoethyl l lysine l nil n ω methyl l arginine l nma ronopterin vas 203 trim enos aminoguanidine pimagedine n 5 1 iminoethyl l ornithine l nio n ω methyl l arginine l nma nitroarginine nna noarg unsorted asymmetric dimethylarginine adma ckd 712 guanidinoethyldisulfide ged gw 273629 indospicine kd 7040 nitroarginine methyl ester name ncx 456 nxn 462 ono 1714 vas 2381 arginase abh n ω hydroxy l arginine noha chlorogenic acid ginseng epicatechin ornithine norvaline lysine alpha aminoacids 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