Substance
Nitroglycerines, nitrates, nitrites

Pathology
Vasodilation causing hypotension. Nitrites are potent oxidizing agents that cause methemoglobinemia.

Symptoms
Headache, hypotension, syncope, skin flushing, nausea, methemoglobinemia, cyanosis, symptoms of cardiac ischemia or cerebrovascular disease, seizures secondary to hypotension.

Emergency Measures
Activated charcoal; administration of intravenous fluids, anticonvulsant medication, hemodialysis, or therapies for GI bleeding (if needed).

Comments
Most cases can be managed successfully with early, aggressive interventions. Drugs for erectile dysfunction should not be taken by patients being treated with nitrates.