CPP 4 - GTN/Aspirin Flashcards
Glyceryl Trinitrate (GTN)
Presentations
a) 0.4mg Nitrolingual spray,
b) 0.6mg Anginine and Lycinate tablets (sublingual use only) (trade/brand names in Australia).
- Query use of Nitrostat 0.3mg or 0.6mg?
Glyceryl Trinitrate (GTN)
Primary emergency indications
a) Cardiac chest pain,
b) Hypertension associated w ACPO,
c) Hypertension associated w ACS.
Glyceryl Trinitrate (GTN)
Contraindications
(Known hypersensitivity plus)
a) Head trauma or haemorrhage,
b) Heart rate >150bpm or <50bmp,
c) Systolic BP <100mmHg,
d) Sildenafil and/or Vardenafil in prev 24hrs,
e) Tadalafil in prev 48hrs.
- Tadalafil (Cialis) may also be prescribed to men for treatment of Benign Prostatic Hypertrophy BPH.
Glyceryl Trinitrate (GTN)
Precautions
a) No previous administration of GTN,
b) Elderly or frail patients,
c) Recent MI,
d) Concurrent use with tocolytics.
- Tocolytics are drugs that slow or stop contractions of uterine smooth muscle to delay preterm labor
Glyceryl Trinitrate (GTN)
Key timings
Onset = 30sec - 2mins,
Peak = 3-5min,
Duration = 15-30min.
Glyceryl Trinitrate (GTN)
Pharmacology/Actions
a) Vasodilation,
b) Reduced preload and afterload,
c) Reduced myocardial oxygen demand,
d) Reduced BP,
e) Mild tachycardia secondary to fall in BP.
Aspirin
Presentations
a) 300mg chewable tablets
b) 300mg soluble or water dispersible tablet
Aspirin
Primary emergency indications
a) Chest pain/discomfort,
b) Acute Coronary Syndrome (ACS).
Aspirin
Contraindications
(Known hypersensitivity plus)
CHHESSA
a) Chest pain assoc w psychostimulant OD, if SBP >160mmHg,
b) Haemophilia or other bleeding disorders,
c) Hypersensitivity to other salicylates,
d) Erosive actively bleeding gastritis or peptic ulcer,
e) Suspected dissecting aortic aneurysm,
f) Severe hepatic or renal disease,
g) Acute febrile illness in children and adolescents.
Aspirin
Precautions
- Active peptic ulcer,
- Asthma,
- Anticoagulant use.
Aspirin
Key timings
Onset: N/A for emerg presentations,
Peak: N/A,
Duration: 8-10 days.
Aspirin
Special notes/Important interactions
NOT to be administered for any condition OTHER THAN chest pain/discomfort of a CARDIAC nature.
Aspirin
Pharmacology/Actions
Analgesic, antipyretic, anti-inflammatory and anti-platelet aggregation agent.
Used to minimise platelet aggregation & thrombus formation, to retard the progression of coronary artery thrombosis in ACS.
Also, inhibits synthesis of prostaglandins, and had anti-inflammatory actions.