Nitroglycerin

Category: pharmacological

Aliases: GTN, Nitrostat, Nitro-Dur

Pharmacological Mechanism

Prodrug → intracellular reduction (mitochondrial ALDH-2) releases nitric oxide → guanylyl cyclase activation → cGMP → smooth muscle relaxation. Predominantly venous dilation (decreases preload) at low doses; coronary + arteriolar dilation at higher doses. Tolerance develops within 24 h of continuous exposure — nitrate-free interval essential.

Half-Life (t½)

SL: 0.04h, IV: 0.04h

Dosing Guidelines

SL: Typical 137 mcg (Range: 5–400 mcg)
TD: Typical 137 mcg (Range: 5–400 mcg)
IV: Typical 137 mcg (Range: 5–400 mcg)
IN: Typical 137 mcg (Range: 5–400 mcg)

Target Organ Systems

cardiovascular

Interactions

NAC (caution): NAC potentiates nitrate-induced hypotension via denitration pathway. [Horowitz 1988]

Pathways It Modulates

PDE5 / NO-cGMP axis (activator) — NO release (cross-link: vasodilator_no_endothelin)
Vasodilator pharmacology (activator) — NO release (mitochondrial ALDH2)

Chemical Identifiers

PubChem CID: 4510
Formula: C3H5N3O9
Molecular weight: 227.09 g/mol
InChIKey: SNIOPGDIGTZGOP-UHFFFAOYSA-N
SMILES: C(C(CO[N+](=O)[O-])O[N+](=O)[O-])O[N+](=O)[O-]