Kuhn M
AACN Clin Issues Crit Care Nurs. 1992 May;3(2):409-22. doi: 10.4037/15597768-1992-2013.
Nitrates have been used for the last 130 years to treat and control the symptoms of angina pectoris. Within the last 15 years, nitrates also have been shown to limit infarct size and to be beneficial in the treatment of patients with severe intractable heart failure, cardiogenic shock, severe mitral and aortic regurgitation, hypertensive episodes, and portal hypertension. The adequate use of nitrates to treat these disorders requires the ability to document a hemodynamic response and to closely monitor the adverse consequences of this therapy. Nitrates work by directly relaxing smooth muscle in resistance and capacitance vessels, thereby causing generalized dilation. Nitrates reduce preload and, at higher doses, reduce systemic vascular resistance and afterload. This chapter reviews the physiologic mechanisms that underlie nitrate therapy, the appropriate indications for nitrate use, the usefulness of specific agents, and their appropriate nursing implications.
在过去的130年里，硝酸盐一直被用于治疗和控制心绞痛症状。在过去15年中，硝酸盐还被证明可限制梗死面积，对治疗严重顽固性心力衰竭、心源性休克、严重二尖瓣和主动脉反流、高血压发作及门静脉高压患者有益。充分使用硝酸盐治疗这些疾病需要有记录血流动力学反应的能力，并密切监测该治疗的不良后果。硝酸盐通过直接舒张阻力血管和容量血管的平滑肌起作用，从而引起全身血管扩张。硝酸盐可降低前负荷，在较高剂量时可降低体循环血管阻力和后负荷。本章回顾了硝酸盐治疗的生理机制、硝酸盐使用的适当指征、特定药物的效用及其适当的护理注意事项。
