Angina Meds

Sep 22, 2016

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

I am not a skilled cat burglar. After trying and failing to keep up to my kids for 70 km, uphill, I was tired. We were in the MS Bike tour, 20th Anniversary Edition, and on the Saturday night we ended up in Clear Lake. Cycling for 5 hours hadn't slowed Eric down at all. He started dragging me and Emily's friend Allison around Clear Lake to play Pokemon Go. Did I mention I was tired? I finally convinced Eric to go back to the cabin so we could get some sleep before we had to ride back to Dauphin on the Sunday. I put the key in the cabin door, but it wouldn't turn. Doris and Emily had the other key, but they wouldn't be back for an hour. The office for the rental cabin was closed, and the phone number went to an answering machine. The only bonus to being exhausted was I didn't have the energy to teach Eric new words to express my frustration at being locked out.

Frustration can lead to innovation. Look at Alfred Nobel and nitroglycerin. Alfred Nobel was a great scientist and inventor in the 1800's. One of his greatest inventions was dynamite which is stabilized nitroglycerin. His inventions made him very wealthy, but he grew very concerned and frustrated about all the war around him and how his inventions were being used to kill people. So in his will he left money to be given out to the person who accomplished "the most or the best work for fraternity among nations, for the abolition or reduction of standing armies and for the promotion of peace congresses." This turned in to the Nobel Peace Prize. Every year since 1901 the Nobel Prize has been awarded for achievements in physics, chemistry, physiology or medicine, literature and for peace.

There was frustration and innovation in Alfred Nobel's dynamite factories as well. Factory workers were exposed to nitroglycerin. The workers were frustrated by the awful headaches they got every Monday morning after being away from the factory for a few days. These headaches went away in a few hours. It was eventually determined that the headaches were caused by the nitroglycerin opening blood vessels in the brains of the workers. Opening up blood vessels in the brain can hurt, but if we open up blood vessels in the heart, we can make physiological heart ache go away. This type of pain is called angina.

You may hear your doctor call chest pain angina pectoris, but many people simply call this kind of chest pain angina. If you suddenly start experiencing chest pain, get to your doctor or the hospital as soon as possible. For those people that the doctor has diagnosed as having angina, she may give them a nitro-spray, or a nitro-patch. Both of these medications contain nitroglycerin, which helps open the blood vessels to the heart. Opening up blood vessels to the heart gets more blood and oxygen to the heart muscle and helps the pain go away. Even though both nitro-spray, and the nitro-patch contain nitroglycerin, they are used in different ways, and are used under different circumstances.

Nitro-spray is used at the first sign of angina, and should help the chest pain immediately. At the first sign of chest pain, sit down or recline, because the nitro-spray will probably make you dizzy. Don't shake the canister. Hold it in an upright position, and remove the plastic cover. Open your mouth, bring the canister as close as possible, and spray the nitro under or onto your tongue. Don't inhale the spray. If the pain persists, you can spray again in 5 minutes. If you need more than 3 sprays in 15 minutes, seek medical attention immediately. Most importantly, if your doctor has prescribed you nitro-spray, always carry it with you.

The nitro-patch works differently than the spray. With the nitro-patch, the nitroglycerin is absorbed slowly through the skin instead of through the mouth. It is designed to be used every day to prevent angina, where the spray is used to treat angina that is occurring now. To apply the patch, first wash your hands, then tear open the package. Hold the patch so that both brown lines are vertical and facing you. Bend the patch forward and back until you hear a light "SNAP". Twist the patch to peel off its plastic backing, and avoid touching the backing. Apply the patch to a hairless area, such as the shoulders, back or hip. Unless your doctor tells you differently, you should only have the patch on for 12 hours, then it should be off for 12 hours. You should also rotate the various places you put the patch each day, to avoid irritating the skin.

Emily and Doris arrived back at cabin at about 10 pm, after Emily's hockey try-out in Dauphin. I probably should have been more sympathetic to Emily. She was frustrated that after biking 5 hours, and playing hockey she was now locked out. However, when their key didn't work either, I wasn't feeling full of the milk of human kindness and probably said some unpleasant things. Eventually, we got Doris's Dauphin Clinic Pharmacy Multi-Tool out of the van. I failed to jimmy the latch on the door. Then finally I removed a screen off a window, removed a strip of wood and jimmied the window lock. From that window, I could reach the door latch and open the door. Frustration to innovation. Good thing it wasn't -10C that night. Gotta win one once in a while.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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