I know its only one day since the nurse cut down my pills but I do feel better. I was up at 7 am wide awake. Thats unusual for me. Shortly I am off with louis and I am itching to try the new spray thing to see if it works.
Mavis is resigned to the fact that we start chemo again with all its misery on Friday. But we will look after each other. Louis knows whats going on because he wont leave her side bless him.
Ive put 2 small puzzles on for today I hope you are still keen for me to carry on with them. I enjoy doing them before I post them. Theres quite a collection of them now.
This is todays pair. The Park was taken last year in a park in Cambridge. The Tall house was taken on holiday a couple of years back. Ive just checked on line how many people have done my puzzlessince I loaded them. I am gobsmacked 900 people have solved them. Thats amazing.
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Right Ive taken my first Puffer waiting 5 mins then me and louis is off. If I am not back in 10 mins it didnt work.
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Wow what a difference. I am back we got further up the lane than of late and my return was at the same pace as outward. Normaly my return is soooo slow and painful . Why didnt I get this when I left hospital why didnt the doctor prescribe it. So many why`s???. Even though the effects last half an hour tops it means I can walk round tescos without looking for a bloody seat to rest on.
Next stop STENT. All I got to do now is look after mavis.
Just got back from Halfords Replaced wipers back and front £32.00. Nothings cheap today is it. Still I will have a clear view of things to come.
How does it work?
Nitrolingual pump spray contains the active ingredient glyceryl trinitrate, which is a type of medicine called a nitrate. It is used to help the heart work more easily. (NB. Glyceryl trinitrate is also available without a brand name, ie as the generic medicine.)
Glyceryl trinitrate works by being converted in the body to a chemical called nitric oxide. This chemical is made naturally by the body and has the effect of making the veins and arteries relax and widen (dilate). When the blood vessels dilate in this way there is more space inside them and hence less resistance. This makes it easier for the heart to pump blood around the body.
Widening the veins also decreases the volume of blood that returns to the heart with each heartbeat. This makes it easier for the heart to pump that blood out again.
As a result of both these actions, the heart does not need as much energy to pump the blood around the body and therefore needs less oxygen.
Glyceryl trinitrate also widens the arteries within the heart itself, which increases the blood and oxygen supply to the heart muscle.
The pain of angina is caused by too little oxygen reaching the heart when its workload increases, such as during exercise. Glyceryl trinitrate improves the oxygen supply to the heart, as well as decreasing the amount of oxygen that the heart needs by making it easier for the heart to pump blood around the body. It can therefore be used to treat angina.
Nitrolingual pump spray is sprayed under the tongue. This area of the mouth has a large supply of blood vessels that allows the medicine to be rapidly absorbed. Glyceryl trinitrate taken in this way is used to give rapid relief from the pain of an angina attack. The spray can also be used to prevent an anticipated attack, for example before exercise or physical effort, emotional stress or exposure to cold.
Glyceryl trinitrate is also available as long-acting tablets, skin patches and ointment that are used regularly each day to help prevent angina attacks. See the factsheets linked at the end of this article for more information.
What is it used for?
Warning!
- Follow the instructions you receive with this medicine. Glyceryl trinitrate spray should be sprayed under the tongue, and the mouth closed after each dose. Do not inhale the spray.
- This medicine may cause dizziness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won’t affect your performance. If you do feel dizzy after taking a dose, sit or lie down until the symptoms pass.
- Drinking alcohol may enhance some of the side effects of this medicine, such as feeling faint or dizzy.
Use with caution in
- Severely decreased kidney function.
- Severely decreased liver function.
- People who have recently had a heart attack.
- Underactive thyroid gland (hypothyroidism).
- People with low levels of oxygen in their blood, eg due to lung disease.
- Dangerously low body temperature (hypothermia).
- Malnutrition.
Not to be used in
- Allergy to nitrates.
- Low blood pressure (hypotension).
- Low volume of circulating blood (hypovolaemia).
- Inflammation of the sac surrounding the heart that stops the heart from beating properly (constrictive pericarditis).
- Fluid in the sac surrounding the heart that prevents the heart beating properly (cardiac tamponade).
- Narrowing of the main artery coming from the heart (aortic stenosis).
- Narrowing of one of the valves in the heart (mitral valve stenosis).
- Heart disease in which the muscle of the heart grows abnormally (hypertrophic obstructive cardiomyopathy).
- Head injury.
- Bleeding in the brain (cerebral haemorrhage).
- Severe anaemia.
- Closed angle glaucoma.
- This medicine is not recommended for use in children.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. It should only be used during pregnancy if the benefits to the mother outweigh any risks to the developing baby. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk. It should only be used by breastfeeding mothers if the benefits to the mother outweigh any risks to the nursing infant. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
- Headache.
- Dizziness.
- Weakness.
- Nausea.
- Flushing.
- Burning or stinging sensation in the mouth.
- A drop in blood pressure that occurs when moving from a lying down or sitting position to sitting or standing, which results in dizziness and lightheadedness (postural hypotension).
- Increased heart rate (tachycardia).
- Decreased heart rate (bradycardia).
- Allergic skin reactions.
- Fainting.
The side effects listed above may not include all of the side effects reported by the drug’s manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
The medicines for erectile dysfunction (impotence) listed below must not be used by people taking glyceryl trinitrate, because the combination can produce a severe drop in blood pressure resulting in dizziness, fainting, or even a heart attack:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra).
If this medicine is taken in combination with other medicines that reduce blood pressure, either as a treatment for high blood pressure (antihypertensives), or as a side effect, there may be an enhanced blood pressure lowering effect. This might make some people feel dizzy. If you do feel dizzy, you should lie down until the symptoms pass. Other medicines that can reduce blood pressure include the following:
- ACE inhibitors, eg enalapril, captopril
- alpha blockers, eg alfuzosin, doxazosin
- alprostadil
- anaesthetics
- angiotensin II receptor antagonists, eg losartan
- certain antipsychotic medicines, eg chlorpromazine
- baclofen
- benzodiazepines, eg temazepam
- beta-blockers, eg propranolol
- calcium channel blockers, eg diltiazem, verapamil, nifedipine
- clonidine
- diuretics, eg furosemide
- hydralazine
- levodopa
- MAOI antidepressants, eg phenelzine
- methyldopa
- minoxidil
- moxisylyte
- moxonidine
- other nitrates, eg isosorbide mononitrate, amyl nitrate (poppers)
- tricyclic antidepressants, eg amitriptyline.
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- maves blog
- IATP
- onestop
- Puzzle page
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