Downers - Nitroglycerin Flashcards

1
Q

What is the initial dose for Nitroglycerine (NTG) IV infusion?
A) 1 mcg/min
B) 5 mcg/min
C) 10 mcg/min
D) 20 mcg/min

A

B) 5 mcg/min

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2
Q

What is the maximum infusion rate of Nitroglycerine (NTG) IV infusion?
A) 100 mcg/min
B) 150 mcg/min
C) 200 mcg/min
D) 250 mcg/min

A

C) 200 mcg/min

IV infusion: 5 mcg/min initial, titrate by 10 mcg/min to max of 200 mcg/min Q5 min

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3
Q

In the case of a Nitroglycerine (NTG) push dose, what is the recommended dose range?
A) 1-5 mcg
B) 10-20 mcg
C) 30-40 mcg
D) 50-100 mcg

A

B) 10-20 mcg

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4
Q

What is the concentration of Nitroglycerine (NTG) when 50mg diluted in 250 mL of normal saline (NS)?
A) 50 mcg/mL
B) 100 mcg/mL
C) 150 mcg/mL
D) 200 mcg/mL

A

D) 200 mcg/mL

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5
Q

How would you dilute Nitroglycerine (NTG) for a push dose concentration of 20 mcg/mL?
A) Dilute 1 mL of NTG in 5 mL NS
B) Dilute 1 mL of NTG in 9 mL NS
C) Dilute 2 mL of NTG in 8 mL NS
D) Dilute 2 mL of NTG in 10 mL NS

A

B) Dilute 1 mL of NTG in 9 mL NS

Concentration: 50mg in 250 mL NS = 200 mcg/mL; dilute 1mL in 9 mL NS for 20 mcg/mL push dosing.

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6
Q

What is the primary mechanism of action (MOA) of Nitroglycerine (NTG)?

A) Beta-adrenergic receptor activation causing smooth muscle contraction
B) Metabolized to nitric oxide (NO), leading to smooth muscle relaxation
C) Inhibition of calcium channels, reducing muscle contraction
D) Competitive antagonism of alpha receptors, leading to vasoconstriction

A

B) Metabolized to nitric oxide (NO), leading to smooth muscle relaxation

MOA: Metabolized to NO = smooth muscle relaxation in venules>arterioles;

MOA: Metabolized to NO = smooth muscle relaxation in venules>arterioles; causes systemic, coronary, and pulmonary vasodilation; bronchodilation; biliary, GI, and GU tract relaxation

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7
Q

What is the duration of action for Nitroglycerine (NTG) following IV administration?
A) 1 minute
B) 5 minutes
C) 10 minutes
D) 30 minutes

A

B) 5 minutes

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7
Q

Nitroglycerine (NTG) primarily causes relaxation in which of the following smooth muscle types? (Multiple Answer)

A) Systemic dilation
B) Coronary dilation
C) Pulmonary dilation
D) Bronchodilation
E) Biliary tract
F) Gastrointestinal (GI) tract
G) Genitourinary (GU) tract

A

H) All of the above

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8
Q

What is the onset time of Nitroglycerine (NTG) when administered intravenously?
A) 10 seconds
B) 30 seconds
C) 1-2 minutes
D) 5 minutes

A

C) 1-2 minutes

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9
Q

How is Nitroglycerine (NTG) primarily metabolized?
A) Renal metabolism
B) Hepatic metabolism
C) Pulmonary metabolism
D) Muscle metabolism

A

B) Hepatic metabolism

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10
Q

What is the half-life of Nitroglycerine (NTG)?
A) 30 seconds
B) 3 minutes
C) 5 minutes
D) 10 minutes

A

B) 3 minutes

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11
Q

What is the primary route of elimination for Nitroglycerine (NTG) after metabolism?
A) Biliary excretion
B) Renal excretion
C) Pulmonary excretion
D) Fecal elimination

A

B) Renal excretion

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12
Q

Which of the following are clinical indications for Nitroglycerine (NTG)? (Multiple Answer)

A) Angina
B) Myocardial infarction (MI)
C) Hypertension (HTN)
D) Hypotension (HoTN)
E) Congestive heart failure (CHF)

A

Correct Answers: A, B, C, E

o Action: For angina, MI, or infarction; HTN, CHF, esophageal spasm, induced HoTN, transient uterine relaxation (bolus)

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13
Q

Which of the following conditions can Nitroglycerine (NTG) treat?

A) Esophageal spasm
B) Cerebral vasospasm
C) Transient uterine relaxation (bolus)
D) Bradycardia

A

A) Esophageal spasm
C) Transient uterine relaxation (bolus)

o Action: For angina, MI, or infarction; HTN, CHF, esophageal spasm, induced HoTN, transient uterine relaxation (bolus)

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14
Q

Which of the following are correct precautions when administering nitroglycerin?
(Select all that apply)

A. Tolerance can be avoided by providing a 12-hour nitrate-free period.
B. Nitroglycerin should be avoided in patients who have taken PDE inhibitors like sildenafil within the past 24 hours.
C. Nitroglycerin can be used safely without considering its interaction with platelet aggregation inhibitors.
D. High doses of nitroglycerin can lead to methemoglobinemia.

A

Answer: A, B, D

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15
Q

Which of the following are true about nitroglycerin’s interactions with other treatments or conditions?
(Select 2)

A. Nitroglycerin may antagonize the effects of heparin.
B. It is recommended to use nitroglycerin in conjunction with sildenafil to maximize its effect.
C. Diminishes platelet aggregation
D. Nitroglycerin enhances platelet aggregation.

A

Answer: A, C

16
Q

What are some common side effects associated with nitroglycerin use?
(Select all that apply)

A. Increased venous capacitance
B. Increased platelet aggregation
C. Decreased cardiac preload
D. Decreased myocardial oxygen demand
E. Coronary vasodilation
F. Headache (H/A)

A

A. Increased venous capacitance
C. Decreased cardiac preload
D. Decreased myocardial oxygen demand
E. Coronary vasodilation
F. Headache (H/A)