Demulen 1/50 and Nitroglycerin

• Generic Name: ethinyl estradiol / ethynodiol
• Dosage Forms: n.a.
• Other Brand Names: Kelnor, Zovia 1/35, Zovia 1/50, Demulen 1/35, Demulen 1/50, Zovia 1/35e, Kelnor 1/50, Kelnor 1/35, Zovia 1/50e

Ethinyl estradiol and ethynodiol diacetate combination is used to prevent pregnancy. It is a birth control pill that contains two types of hormones, ethinyl estradiol and ethynodiol diacetate, and when taken properly, prevents pregnancy. It works by stopping a woman's egg from fully developing each month. The egg can no longer accept a sperm and fertilization (pregnancy) is prevented.

No contraceptive method is 100 percent effective. Birth control methods such as having surgery to become sterile or not having sex are more effective than birth control pills. Discuss your options for birth control with your doctor.

This medicine does not prevent HIV infection or other sexually transmitted diseases. It will not help as emergency contraception, such as after unprotected sexual contact.

This medicine is available only with your doctor's prescription.

• Generic Name: nitroglycerin
• Dosage Forms: n.a.
• Other Brand Names: Gonitro, Nitrolingual, NitroMist, Nitrostat, Nitro-Time, Gonitro, Minitran, Nitro TD Patch-A, Nitro-Dur, Nitro-Bid, Nitrol Appli-Kit, Rectiv

Management of angina pectoris secondary to CAD.

Short-acting preparations (e.g., sublingual nitroglycerin tablets, nitroglycerin spray) used for acute relief of angina; also may be used for acute prophylactic management in situations likely to provoke angina attacks.

Sublingual nitroglycerin is considered the drug of choice for acute relief of angina pectoris because it has a rapid onset of action, is inexpensive, and its efficacy is well established.

Long-acting preparations (e.g., oral or topical nitroglycerin) used for long-term prophylactic management of chronic stable angina.

While β-blockers are recommended as the anti-ischemic drugs of choice in most patients with chronic stable angina, long-acting nitroglycerin preparations may be substituted or added in patients who do not tolerate or respond adequately to β-blockers.

Acute symptomatic relief of chest pain in patients with NSTE ACS, including unstable angina and non-ST-segment-elevation MI (NSTEMI).

Sublingual nitroglycerin (0.3–0.4 mg every 5 minutes for up to 3 doses) is recommended in patients with NSTE ACS who have continuing ischemic pain; IV nitroglycerin may be used in patients with heart failure, hypertension, or persistent ischemia not relieved with sublingual nitroglycerin and administration of a β-blocker. Topical or oral nitrates may be an acceptable alternative to IV therapy in patients who do not have refractory or recurrent ischemia.

Management of patients with acute MI.

Expert guidelines for the management of ST-segment-elevation MI (STEMI) state that IV nitroglycerin may be beneficial in patients with STEMI and heart failure or hypertension.

Experts state there is no role for the routine use of oral nitrates during the convalescent phase of STEMI.

Systemic hypotension with resultant worsening of myocardial ischemia is a potential complication of nitroglycerin therapy. Therefore, avoid use in patients with or at risk of hypotension.

Avoid use in patients with marked bradycardia (e.g., <50 bpm) or tachycardia (e.g., >100 bpm) and those with suspected right ventricular infarction.

IV nitroglycerin is used to control BP in perioperative hypertension, especially hypertension associated with cardiovascular procedures; to control BP in patients with severe hypertension or in hypertensive crises for the immediate reduction of BP in patients in whom such reduction is considered an emergency (hypertensive emergencies), especially those associated with coronary complications (e.g., coronary ischemia, acute coronary insufficiency, acute left ventricular failure, postoperative hypertension [especially following coronary bypass surgery]) and/or acute pulmonary edema; and to produce controlled hypotension during surgical procedures.

IV nitroglycerin has been used in the management of acutely decompensated (e.g., congestive) heart failure and other low cardiac-output states.

Current guidelines recommend a combination of drug therapies (e.g., ACE inhibitors, angiotensin II receptor antagonists, angiotensin receptor-neprilysin inhibitors [ARNIs], β-blockers, aldosterone receptor antagonists) in adults with heart failure to reduce morbidity and mortality.

IV vasodilators not shown to improve outcomes in patients hospitalized for heart failure; however, IV nitroglycerin may be considered as adjunct to diuretic therapy for relief of dyspnea in patients hospitalized for acutely decompensated heart failure who do not have symptomatic hypotension.

Particularly useful in patients with heart failure and hypertension, coronary ischemia, or substantial mitral regurgitation.

Tachyphylaxis may develop within 24 hours; some patients may develop resistance to even high doses.

Used adjunctively in the management of cocaine overdose to reverse coronary vasoconstriction and/or relieve hypertension or chest discomfort.