Glyceryl Trinitrate

Question 1

How does GTN work?

Answer 1

Smooth muscle relaxant leading to vasodilations
- Venodilation leads to readuced Preload
- Ateriodilation reduces afterload

Question 2

What are the 7 Contraindications for GTN?

Answer 2

• VT
• HR >150
• HR <50 (Excluding AD)
• BP <100
• PDE5 Inhibitors
• Riociguat (Adempas) (Current use)
• Bleeding in Pregnancy

Question 3

What are some PDE5 inhibitors?

Answer 3

• Viagra
• Cialis
• Levitra
• Spedra

Question 4

What are the three precautions for GTN?

Answer 4

• Lower doses for frail/ pt who have not had GTN before
• Preterm labour - concurrent use with other tocolytics (Medications used to slow or stop contractions
• Right ventiruclar MI or inferior STEMI with a BP <160, use cautiously

Question 5

GTN presentation

Answer 5

• 300mcg S/L tablet
• 600mcg S/L table
• 50mg, (0.4mg/hr) patch

Question 6

What is Riociguat and PDE5 inhibitors used for?

Answer 6

• Arterial Hypertension

Question 7

When can GTN be administered after PDE5 inhibitors? (Times)

Answer 7

• 12 hours for Spedra
• 24 Hours for Levitra and Viagra
• 48hours for Cialis

Question 8

What are some Adverse effects for GTN?

Answer 8

CV: Hypotensio, tachycardia
CNS: Headache, Dizziness, Syncope
Other: Skin Flushing