Sublingual nitroglycerin for treatment of acute chest pain can cause -

Ans. is 'b' i.e., Headache o Due to vasodilatation there may be tachycardia, palpitation, flushing, headache, dizziness and fainting may occur.Uses of nitratesAngina pectorisMICHF and acute LVF - nitroglycerine i.v. can be used - Act by decreasing preload (LV filling pressure).Biliary colic and esophageal spasm (achalasia cardia)Acute coronary syndrome (unstable angina and non-ST segment elevation MI).Cyanide poisoningAdverse effectso Due to vasodilatation tachycardia, palpitation, flushing, headache, dizziness and fainting may occur,o Rashes are common particularly with pentaerythritol tetranitrate.o Methemoglobinemia.o Sildenafil causes dangerous potentiation of nitrate action (cGMP is increased by nitrates and its breakdown by phosphodiesterase is inhibited by sildenafil - marked accumulation of cGMP) - severe hypotension, MI and death may occur - the only contraindications of nitrates use are hypotension or simultaneous use of sildenofil.