Drug General Information (ID: DDI2W9X8UV)
Drug Name			Nitroglycerin		Drug Info		Nesiritide		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Vasodilator Agents				Recombinant Natriuretic Peptide
Structure

Mechanism of Nitroglycerin-Nesiritide Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Nitroglycerin				Nesiritide
Mechanism		Antihypertensive agent Guanylate cyclase  Agonist				Antihypertensive agent Guanylate cyclase  Agonist
Key Mechanism Factor 1
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions.     Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Nitroglycerin and Nesiritide

Recommended Action
Management		Whether used alone or with other agents, nesiritide should be administered only in settings where blood pressure can be closely monitored. The dosage should be reduced or the drug discontinued in patients who develop hypotension.

References
1	Product Information. Natrecore (nesiritide) Scios Inc, Sunnyvale, CA.