New Ways to Take Nitroglycerin

QUESTION: Can you tell me about the new ways to take nitroglycerin?
------------------------------------------------------------------------------
ANSWER: Nitroglycerin is the drug most often given for angina, which is chest
pain and pressure caused by coronary artery disease. In coronary artery
disease, arteries that supply the heart with blood are blocked by plaques
(also known as "atheroma") which are composed of fatty materials like
cholesterol. The blocked heart arteries can't carry as much blood as the
heart muscle needs, and the result is angina. Nitroglycerin temporarily
widens those blocked arteries, allowing more blood to flow to the heart
muscle.
You are probably most familiar with the tiny "nitro" pill that is placed
under the tongue and allowed to dissolve there. This immediate-acting
nitroglycerin is also available in a spray that can be sprayed under the
tongue, or it can be injected straight into a vein. Any of these forms of
nitroglycerin are short-acting, effective for only about 15-20 minutes.
Intermediate-acting nitroglycerin lasts for a few hours and is used to
prevent angina instead of to treat it. This pill or capsule is either
swallowed or placed in the mouth between the cheek and jaw. It begins to work
within about half an hour.
Longer-acting nitroglycerin is prepared as an ointment that is absorbed
through the skin. It is supplied in a tube like toothpaste and is squirted
onto a piece of paper that is printed with a ruler. The exact prescribed
amount of ointment is applied to the ruler paper, then the paper is used to
spread the ointment on an area of skin that is about six inches long by at
least three inches wide. Most people apply it to the chest, but it can be
applied to any nonhairy part of the upper body. Do not apply the ointment to
your legs or feet, because many people with heart disease have decreased
circulation there. If the circulation is poor, the nitroglycerin won't be
absorbed properly.
Another way to use nitroglycerin is in the form of a patch that is
already prepared, requiring no ointment or preparation by the user. Many
people prefer these "transdermal patches" because they are convenient. These
patches are available in several doses, and should be used as packaged, and
not cut in half.