HealthCare

Nitrocin Lingual Spray is a metered dose spray containing metered sprays of glyceryl trinitrate. Each metered dose of 70 micro litres of Nitrocin Lingual Spray delivers glyceryl trinitrate (0.4mg per spray) in the form of spray droplets onto or under the tongue. It contains Absolute ethanol as inactive ingredient.

The principal pharmacological action of glyceryl trinitrate is relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins with more prominent effects on the latter. Dilation of the post-capillary vessels, including large veins, promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end diastolic blood pressure. The Arteriolar relaxation reduces systemic vascular resistance and arterial blood pressure. The mechanism by which glyceryl trinitrate relieves angina prectoris is not fully understood. Myocardial oxygen consumption or demand is decreased by both the arterial and venous effects of glyceryl trinitrate and  a more favorable supply-demand ratio is achieved. Therapeutic doses of glyceryl trinitrate may reduce systolic, diastolic and mean arterial blood pressure. Effective coronary perfusion pressure is usually maintained, but can be compromised if blood pressure falls excessively or increased heart rate decreases diastolic filling time. Elevated central venous and pulmonary capillary wedge pressures, pulmonary vascular resistance and systemic vascular resistance are also reduced by glyceryl trinitrate therapy. Heart rate is usually slightly increased, presumably a reflex response to the fall in blood pressure. Cardiac index may be increased, decreased, or remain unchanged. Patients with elevated left ventricular filling pressure and systemic vascular resistance values in conjunction with a depressed cardiac index are likely to experience an improvement in cardiac index . On the other hand, when filling pressures and cardiac index are normal, cardiac index may be slightly reduced.

 
Nitrocin lingual spray is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery disease. At the onset of an attack of angina pectoris, one or two metered sprays (0.4mg) of Nitrocin Lingual Spray should be administered onto or under the tongue without inhaling. The optimal dosage may be repeated approximately every 5 minutes as needed. No more than 3 metered sprays are recommended within a 15 minute period. Dosage must be individualized & should be sufficient to provide relief. If chest pain persists after a total of 3 spray, prompt medical attention is recommended. Nitrocin lingual spray may be used prophylactically 5 to 10 minutes before engaging in activities that might precipitate an acute attack. Such as climbing stairs, going outdoors in cold weather or having sex.

Priming the Container: Nitrocin Lingual Spray should be primed prior to the first use. Before using this medication, the spray should be primed by spraying once into the air, away from oneself & others or towards the floor. It should be re-primed with one spray if it is not used within 6 weeks.

During use the patients should rest, ideally in the supine or sitting position. The container should be held vertically with the valve head uppermost and the spray orifice as close to the mouth as possible. Pressure on the spray head will release a single dose of 0.4mg glyceryl trinitrate. The dose should preferably be sprayed into the mouth on or under the tongue by pressing the button firmly and the mouth should be closed immediately after each dose. The spray should not be inhaled. Patients should be instructed to familiarize themselves with the position of the spray orifice. Which can be identified by the finger rest on top of the valve can identify, in order to facilitate orientation for administration at night.

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