Describe the role of nitrates, their route of administration and their side effects while being used in the management of angina pectoris.
Role of Nitrates in Angina Pectoris:
Nitrates act as potent vasodilators, reducing myocardial oxygen demand. Venous dilation lowers venous return to the heart (preload), decreasing cardiac workload. Arterial dilation reduces systemic vascular resistance (afterload), further easing heart strain. They also dilate epicardial coronary arteries and enhance collateral circulation, improving oxygen supply to ischemic myocardium.
Routes of Administration: Sublingual for rapid relief of acute attacks, oral or transdermal for long-term prophylaxis, intravenous for severe or unstable angina.
Side Effects: Commonly cause headache, facial flushing, dizziness, reflex tachycardia, and hypotension, particularly with overdose or combined vasodilator therapy.
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