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The medical use of nitroglycerin is for the treatment of angina and heart failure. The chemical nitroglycerin is commonly referred to as "glyceryl trinitrate" or "GTN" in medicine to distinguish it from nitroglycerin as used as an explosive. However, the drug is often referred to as "nitro" colloquially. Its use began with the experiments of William Murrell, which were reported in 1879. It is on the WHO Model List of Essential Medicines, a list of the most important medication needed in a basic health system. The mechanism of nitric oxide (NO) generation from GTN and the metabolic consequences of this bioactivation are not entirely understood. ==Medical uses== Nitroglycerin is used for the treatment of angina,〔JRCALC National Clinical Guidelines GTN http://www2.warwick.ac.uk/fac/med/research/hsri/emergencycare/prehospitalcare/jrcalcstakeholderwebsite/guidelines/glyceryl_trinitrate_gtn_suscard_gtn.pdf〕 acute myocardial infarction,〔 severe hypertension, and coronary artery spasms. ===Angina=== It is useful in decreasing angina attacks, perhaps more so than reversing angina once started, by supplementing blood concentrations of nitric oxide, also called endothelium-derived relaxing factor, before the structure of the nitric oxide as the responsible agent was known. This led to the development of transdermal patches of glyceryl trinitrate, providing 24-hour release.〔(【引用サイトリンク】title=mknitro )〕 However, the effectiveness of glyceryl trinitrate is limited by development of tolerance/tachyphylaxis within 2–3 weeks of sustained use. Continuous administration and absorption (such as provided by daily pills and especially skin patches) accelerate onset of tolerance and limit the usefulness of the agent. Thus glyceryl trinitrate works best when used only short term, pulse dosing. Glyceryl trinitrate is useful for acute myocardial infarction (heart attack) and pulmonary edema, again working best if used quickly, within a few minutes of symptom onset, as a pulse dose. It may also be given as a sublingual or buccal dose in the form of a tablet placed under the tongue or a spray into the mouth for the treatment of an angina attack.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Medical use of nitroglycerin」の詳細全文を読む スポンサード リンク
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