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西藥品查詢
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外觀描述:
小包

醫令代碼:
28523

商品名:
NITRODERM-TTS

中文名:
護心貼片

學名:
Nitroglycerin

劑型:
PIECE

孕婦用藥分級:
C 級

健保碼:
B010671340

藥品許可證:
衛署藥輸字第010671號

仿單下載:

用藥指導單張:

ATC7藥理類別:

結構式 :

1,2,3-trinitroxypropane 1,3-dinitrooxypropan-2-yl nitrate propane-1,2,3-triyl trinitrate


UpToDate:

藥理作用 :
Nitrglycerin形成一氧化氮自由基(free radical nitric oxide),此自由基會活化鳥嘌呤核甘酸環化酉每(guanylate cyclase),而使得平滑肌和其他組織內的環狀鳥嘌呤核甘3'5'單磷酸鹽[guanosine 3'5'monophosphate(cyclic GMP)]增加。這作用最終會導致調節平滑肌收縮狀態的肌蛋白氫鍵發生去燐基作用而引起血管舒張。

適應症:
預防及治療冠狀動脈疾病引起之狹心症發作。

用法用量:

NitrodermTTS 每天使用1片(0.2mg/hr),需要時可增加1片。要轉換黏貼皮膚的部位。每日最高劑量0.8mg/hr。

本品不是用來立即解除突發的心絞痛,若發生突發狀況,應使用可迅速作用的硝酸鹽製劑。


副作用:
頭暈、頭痛、臉部潮紅、虛弱、心悸、血壓降低,這些症狀會隨時間慢慢減弱。

藥物動力學:

Absorption
Rapid.

Distribution
Vd is 3 L/kg. Protein binding is approximately 60% (parent); 1,2 dinitroglycerin, 60%; 1,3 dinitroglycerin, 30%.

Metabolism
Primarily metabolized in the liver by nitrate reductase; known sites of extrahepatic metabolism include red blood cells and vascular walls. Metabolized to inorganic nitrate and the active 1,2 and 1,3 dinitroglycerols.

Elimination
Serum t ½ is 3 min and 1 to 8 min (sublingual). Cl is 1 L/kg/min.

Onset
1 to 2 min (IV), 1 to 3 min (sublingual), 1 h (extended-release).

Peak
1 to 4 h (immediate-release tablet), 6 to 7 min (sublingual), 2 h (transdermal).

Duration
3 to 5 min (IV), 30 to 60 min (sublingual), 5 h (extended-release), up to 12 h (topical ointment).


交互作用:

Alcohol
Severe hypotension and CV collapse may occur.

Alteplase
Concurrent administration decreases thrombolytic effects of alteplase.

Aspirin
Vasodilatory and hemodynamic effects of nitroglycerin may be enhanced.

Calcium channel blockers
Symptomatic orthostatic hypotension may occur.

Dihydroergotamine
May increase systolic BP and decrease antianginal effects.

Heparin
May decrease anticoagulation effect when used in conjunction with IV nitroglycerin.

Phosphodiesterase type 5 inhibitors (eg, sildenafil, tadalafil, vardenafil)
Because the hypotensive effects of nitrates may be potentiated, concomitant use of any form of organic nitrates is contraindicated in patients receiving phosphodiesterase type 5 inhibitors.


禁忌:
具有早期心肌梗塞嚴重貧血,顱內壓昇高及對Nitoglycerin過敏之患者,禁止使用本品。

注意事項:
1. 以最低有效量來緩解心絞痛之發作,切忌以大量至耐增加。
2. 過量投與Nitroglycerin會引起嚴重頭痛,不可與Viagra併用。

藥品保存方式:
藥品應置於攝氏 15 ~ 25 度乾燥處所;如發生變質或過期,不可再使用。

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