Which two side effects are most closely associated with the use of nitroglycerin tablets? (Select all

A. Erectile dysfunction: This condition is not a direct physiological side effect of nitrate therapy. While phosphodiesterase inhibitors used for this condition are contraindicated with nitrates due to synergistic hypotension, the medication itself does not cause sexual dysfunction. It primarily affects vascular smooth muscle rather than autonomic pathways. B. Backache: Nitroglycerin lacks a known mechanism for inducing musculoskeletal pain in the spinal region. Common adverse effects are typically related to systemic vasodilation and subsequent compensatory hemodynamic responses. This symptom is not documented as a frequent or characteristic complication of sublingual nitrate administration. C. Diarrhea: This medication focuses on vascular smooth muscle relaxation rather than gastrointestinal motility. Nitrates do not typically irritate the enteric lining or accelerate peristalsis to cause frequent loose stools. Side effects usually manifest in the cardiovascular and neurological systems due to rapid vasodilation. D. Dizziness: Rapid systemic vasodilation leads to a transient decrease in blood pressure and cerebral perfusion. This orthostatic effect often follows the administration of potent vasodilators as the body adjusts to decreased venous return. It remains a significant safety concern during acute anginal management. E. Headache: The dilation of cerebral vessels increases intracranial pressure and activates pain receptors. This is the most common adverse reaction due to the drug's non-specific effect on all vascular beds. The intensity often correlates with the speed of onset of the medication.