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View Full Version : What Happens If You Take A Nitroglycerin Tablet Without Needing It?


Markxxx
06-10-2011, 11:00 PM
You know the nitroglycerin tablets, that people with angina take. Now I have a health heart (so far as I know) what happens, if I were to put one of those tablets under my tongue.

I am not planning to do this, and I don't have access to them, I was just wondering. Would it make my heart beat faster, I believe it's a vasodilator right?

beowulff
06-10-2011, 11:12 PM
You get a roaring headache.

Also, your blood pressure may drop enough to make you faint upon standing. Other than that, I don't think it would cause any serious problems.

When I was getting my cardiac problems sorted out, I was on isosorbide dinitrate, and the way I knew it was working is I had a constant headache.

SeaDragonTattoo
06-10-2011, 11:15 PM
It would probably make you dizzy and give you a headache. It could make you pass out if your blood pressure drops fast enough. It would lower your heart rate.

In the animal ER, we apply a paste to patients' "armpits" and have to be very careful, using gloves and/or a tongue depressor to apply the nitro paste, or we risk side effects from it absorbing through the skin of a finger.

needscoffee
06-11-2011, 12:40 AM
What is the headache due to?

Crescend
06-11-2011, 12:55 AM
What is the headache due to?Vasodilation. Nitroglycerine makes your blood vessels dilate, which is associated with headache, while vasoconstriction is associated with stopping headache. This is why a number of headache medications (ergot alkaloids, the various triptans, caffeine, etc) are vasoconstrictors. This is also why anything that's a potent vasodilator can give you a roaring headache - one of the more reliable ways of getting an instant headache is a histamine injection.

Markxxx
06-11-2011, 01:21 AM
When I was a revenue mgr on of my staff took them, till she got her angioplasty.

So everyone gets headaches? Even the cardiac patients? I guess it's better than dying :)

Autolycus
06-11-2011, 02:09 AM
You explode. Or a roaring headache. One or the other.

thirdname
06-11-2011, 02:11 AM
Does the pill explode if you drop it?

John DiFool
06-11-2011, 07:34 AM
Or hit with a hammer? I'm serious.

njtt
06-11-2011, 08:11 AM
I think, to get a real explosion out of nitro, you need to have a fair bit of it, probably more than is in a medical dose.

I had a high school friend who once told me that he had synthesized a small amount of nitroglycerin in his home chemistry lab. He had it in a test tube which he flung down hard, in the street, to try and make it explode. However, he told me that in fact it just "hissed a bit".

Admittedly it is quite possible that he was putting me on, but I should think that if he was lying he would have given the story a more spectacular ending, and certainly my group of friends were not averse to making small amounts of unstable explosive compounds. I and other friends would quite often make nitrogen tri-iodide (very easy: just pour some ammonium hydroxide over some iodine crystals, and then let it dry) which would give satisfyingly loud cracking noises if hit with something. Maybe you could get medical nitro to do that.

(Of course, if my friend really did try to make nitroglycerin, it is more than likely that his synthesis was not very good, and that his test tube in fact contained little or none of the actual stuff. It occurs to me that the hiss might just have been something on the road interacting with the nitric acid he used.)

Cub Mistress
06-11-2011, 08:35 AM
When I was a revenue mgr on of my staff took them, till she got her angioplasty.

So everyone gets headaches? Even the cardiac patients? I guess it's better than dying :)

pretty much everyone gets the headache. Many nurses automatically bring the prn Tylenol along with the nitro. Nitropaste doesn't seem to have such a dramatic effect.

AaronX
06-11-2011, 09:55 AM
Vasodilation. Nitroglycerine makes your blood vessels dilate, which is associated with headache, while vasoconstriction is associated with stopping headache. This is why a number of headache medications (ergot alkaloids, the various triptans, caffeine, etc) are vasoconstrictors. This is also why anything that's a potent vasodilator can give you a roaring headache - one of the more reliable ways of getting an instant headache is a histamine injection.

Which is asprin? It stops headaches, yet helps the heart.

beowulff
06-11-2011, 09:59 AM
Which is asprin? It stops headaches, yet helps the heart.

Asprin is a mild anti-coagulator, so it helps prevent blood clots. It's also an anti-inflammatory, so it may tend to prevent irritation in the linings of arteries, which might reduce plaque buildup. I don't believe it has any significant blood vessel dilation effects.

Crescend
06-11-2011, 10:52 AM
Asprin is a mild anti-coagulator, so it helps prevent blood clots. It's also an anti-inflammatory, so it may tend to prevent irritation in the linings of arteries, which might reduce plaque buildup. I don't believe it has any significant blood vessel dilation effects.It has a whole bunch of effects. It prevents the formation of vasoconstrictive factors (like thromboxanes), but it also prevents the formation of vasodilatory factors (like prostacyclins). There's some cross-talk with other pathways like bradykinins. Overall, many of those effects are a wash, and its main effects are analgesic, anti-inflammatory, and anti-platelet aggregation - which is what it's prescribed for. The trick is that the enzyme that aspirin inhibits is found in multiple places in the body, but most of those places can make more of it after aspirin knocks it out; the places that can't regenerate the enzyme (i.e., platelets) largely determine the overall effect.

Interestingly, because similar factors also have an effect on bronchoconstriction/dilation, there are some variants of asthma that are sensitive to aspirin - in those cases, taking aspirin will prevent the formation of bronchodilatory factors, causing an asthma attack. It's not common, though.

clairobscur
06-11-2011, 10:55 AM
I didn't know nitroglycerin was still used. I thought it was a medication of the past (say, till the 50s or so)

Eva Luna
06-11-2011, 11:31 AM
Yeah, the not very bright husband of my ex-BF's cousin did this once maybe 10 years ago at a big family dinner; got indigestion, decided he was having a heart attack although he's never had any heart issues, and took someone else's nitro tablet. That's when he ended up in the ER.

Did I mention he wasn't very bright?

KarlGauss
06-11-2011, 01:35 PM
It would probably make you dizzy and give you a headache. It could make you pass out if your blood pressure drops fast enough. It would lower your heart rate.
Pardon my nitpickiness, but all other things being equal, anything that drops your blood pressure will lead to a compensatory increase in heart rate.

I'm wondering if the reason you said that NTG lowers the heart rate is because that could explain its anti-angina effect. Although slowing the heart rate is part of the mechanism for beta-blockers (http://en.wikipedia.org/wiki/Beta_blocker)' anti-angina effect, it doesn't apply to NTG.

NTG prevents/relieves angina by both dilating arteries in the heart itself (thereby bringing more oxygen to the heart) and by causing blood to pool in the veins of the body. Such pooling means that there will be less blood delivered back to the heart which means, in turn, that the heart muscle isn't strained as much (and thus can get by with less oxygen than when not experiencing that NTG effect).

billfish678
06-11-2011, 02:04 PM
If you are Italian American its a very badddd thing.

Take one and its bada bing bada boom!

GythaOgg
06-11-2011, 03:09 PM
I didn't know nitroglycerin was still used. I thought it was a medication of the past (say, till the 50s or so)

No, it's still very widely used for treatment of angina - it's fast, it can absorb through the oral mucous membrane under the tongue, and it does the job. It's still around because it works and works very well. As mentioned, it comes in a number of formulations - the classic small tablets, a paste/ointment form, a spray meant for spraying under the tongue, and a skin patch that can be work for several hours.

As a nurse, I've gotten nitropaste on my hands more than once. The headache is classic, but it passes pretty quickly. Never got enough on me to feel fainty, though.

KlondikeGeoff
06-11-2011, 05:01 PM
I and other friends would quite often make nitrogen tri-iodide (very easy: just pour some ammonium hydroxide over some iodine crystals, and then let it dry) which would give satisfyingly loud cracking noises if hit with something. Maybe you could get medical nitro to do that.

Wow, that takes me back. I was a chemistry freak, and had a pretty good lab even before I took Chemistry in HS. I loved to make nitro tri-iodide, pouring it on a piece of filter paper to dry. Made a nice loud noise when hit, alright.

I made nitroglycerin too, but can't remember exactly how. I think it was just nitric acid and glycerin with sulfuric acid as a desiccant. I made a tube of it, but was too chicken to try to detonate it, so poured it out into the dirt out back. All this was about 70 years ago. I am a bit wiser now.

billfish678
06-11-2011, 05:06 PM
Wow, that takes me back. I was a chemistry freak, and had a pretty good lab even before I took Chemistry in HS. I loved to make nitro tri-iodide, pouring it on a piece of filter paper to dry. Made a nice loud noise when hit, alright.


As a public safety message I want to point out that stuff is both extremely unstable and extremely powerful. You've been warned.

Andy
06-11-2011, 05:09 PM
Nitroglycerine is just a prodrug in this situation; the active compound is nitric oxide, NO, which has got to be the simplest/lowest molecular weight biologically active compound out there.
Hydrazoic acid, HN3, is also a potent vasodilator. It gives an appallingly intense, albeit short lived, headache.

Pai325
06-11-2011, 05:57 PM
They gave me a nitroglycerine tablet in the ER when they were trying to figure out if I was having a heart attack. I don't remember anything happening, but that might have been because I was in so much pain. It was not heart; it was my first (and last) gall bladder attack. I had it out the next week.

AaronX
06-12-2011, 01:58 AM
It has a whole bunch of effects. It prevents the formation of vasoconstrictive factors (like thromboxanes), but it also prevents the formation of vasodilatory factors (like prostacyclins). There's some cross-talk with other pathways like bradykinins. Overall, many of those effects are a wash, and its main effects are analgesic, anti-inflammatory, and anti-platelet aggregation - which is what it's prescribed for. The trick is that the enzyme that aspirin inhibits is found in multiple places in the body, but most of those places can make more of it after aspirin knocks it out; the places that can't regenerate the enzyme (i.e., platelets) largely determine the overall effect.

Interestingly, because similar factors also have an effect on bronchoconstriction/dilation, there are some variants of asthma that are sensitive to aspirin - in those cases, taking aspirin will prevent the formation of bronchodilatory factors, causing an asthma attack. It's not common, though.

Which of these effects cure headaches?

Khan
06-12-2011, 11:44 AM
Pardon my nitpickiness, but all other things being equal, anything that drops your blood pressure will lead to a compensatory increase in heart rate.

...

NTG prevents/relieves angina by both dilating arteries in the heart itself (thereby bringing more oxygen to the heart) and by causing blood to pool in the veins of the body. Such pooling means that there will be less blood delivered back to the heart which means, in turn, that the heart muscle isn't strained as much (and thus can get by with less oxygen than when not experiencing that NTG effect).

You're right about the decreased O2 demand and the effect of decreased blood pressure on heart rate. Giving a little nitro can decrease O2 demand, but too much can have systemic effects that drop blood pressure and make the heart beat faster, thereby actually INCREASING the strain. What's tricky is that the tipping point where you go from decreased O2 demand to reflex tachycardia can vary a lot from person to person and is very difficult to predict.

With someone who has nitro pills for angina, the goal is pain relief. Less pain is more calm, more calm is less stress on the heart while you wait for the ambulance to pick you up and take you to the hospital for an EKG, blood tests, and maybe a trip to the cath lab to get a stent put in.

Someone else takes it who doesn't need it? Yeah, headache and maybe dizziness upon standing. That's what you get for taking grandpa's medicine, ingrate. ;)

BigT
06-12-2011, 05:48 PM
Which of these effects cure headaches?

Short answer: the reduced proglastandins, as proglastandins are not only inflammatory but also transmit pain.

Longer answer: Aspirin's primary mode of action is to stop the production of the COX enzymes. COX-1 is used to create thromboxanes, while COX-2 is used to create proglastandins. But it doesn't just block COX-2, it also modifies it so tjat, instead of producing proglastandins, it also produces lipoxins, which are anti-inflammatory.

The lack of proglastandins reduce the transmission of pain, but, due to the opposite effect of the lack of thromboxanes, are not that anti-inflammatory. But the lipoxins make up for this. Both reduction in pain transmission and anti-inflammatory actions help to reduce headaches.

Rysdad
06-12-2011, 08:36 PM
So everyone gets headaches? Even the cardiac patients? I guess it's better than dying :)

I had bronchitis, and I went to the emergency room. I made the mistake of saving that it hurts ::here:: while pointing to my chest. Among other things they did was to give me a nitro pill.

They said it would give me a bad headache.

It didn't.

Still, to this day, I can say that I've never, ever had a headache.

So, in answer to your question...no.

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