CVS: Glyceryl Trinitrate (GTN)

Question 1

What class of Meds is Glyceryl Trinitrate (GTN)?

Answer 1

Nitrate vasodilator

Question 2

What does Glyceryl Trinitrate (GTN) treat? (3 things)

Answer 2

1. Angina (Tx + Prophylaxis)
2. Congestive HF
3. Anal fissures

Question 3

What is the GENERAL MOA of Glyceryl Trinitrate (GTN)?

Answer 3

Vasodilation of arteries + veins

Question 4

What is the IN-DEPTH MOA of Glyceryl Trinitrate (GTN)? (5 steps)

Answer 4

1. Causes relaxation of Vasc SMC
2. Arteriolar + Venous dilation
3. Increased blood flow to Myocardium
4. Reduced Cardiac preload + afterload
5. Decreases myocardial wall stress (aka Angina symptoms)

Question 5

What route should Glyceryl Trinitrate (GTN) be given? (3 things)

Answer 5

1. Sublingual (spray / tablets) for angina
2. IV for HF
3. Rectum (ointment) for anal fissures

Question 6

What are the Min / Max Doses for Glyceryl Trinitrate (GTN)?

Answer 6

1. Min: 400 micrograms
2. Max: 800 micrograms (2 doses 5 mins apart)

Question 7

What are the Monitoring Requirements for Glyceryl Trinitrate (GTN)?

Answer 7

BP + HR (when given by IV)

Question 8

What are the Side fx of Glyceryl Trinitrate (GTN)? (5 things)

Answer 8

1. Dizziness
2. Nausea
3. Anaemia
4. Hypoglycaemia
5. Postural hypotension

Question 9

What advice should you tell a patient taking Glyceryl Trinitrate (GTN)? (2 things)

Answer 9

1. Show them how to administer spray sublingually
2. Seek medical help if 2 doses 5 mins apart don’t resolve symptoms

Question 10

What are the CI for taking Glyceryl Trinitrate (GTN)? (9 things)

Answer 10

1. Anaemia
2. Raised ICP (bc cerebral haemorrhage)
3. Aortic / Mitral Stenosis
4. Cardiac tamponade
5. Constrictive pericarditis
6. Hypertrophic cardiomyopathy
7. Toxic pulmonary oedema
8. Hypotension
9. Hypovolaemia

Question 11

When should Glyceryl Trinitrate (GTN) be used with Caution? (8 things)

Answer 11

1. Hypothermia
2. Hypoxaemia
3. Hypothyroidism
4. HF
5. MI recent Hx
6. Cardioversion / Diathermy
7. Malnutrition
8. Tolerance!