GTN

Question 1

MOA

Answer 1

vasodilator

acts on vascular smooth muscle to cause venous and arterial vasodilation, with the prominent effect being on veins

Question 2

Indications

Answer 2

Myocardial ischaemia,
Cardiogenic pulmonary oedema and
Hypertension

Question 3

Contra indications

Answer 3

Systolic BP less than 100 mmHg.
> Heart rate less than 40/minute.
> Heart rate greater than 130/minute if the primary clinical problem is myocardial ischaemia, STEMI or cardiogenic pulmonary oedema.
> Heart rate greater than 150/minute 
> Ventricular tachycardia.

Question 4

Cautions

Answer 4

STEMI, particularly STEMI involving the right ventricle
The patient is small, frail, or physiologically unstable
Poor perfusion. Poor perfusion is a sign of reduced cardiac output which may fall further
Dysrhythmia. may cause a reduced cardiac output which may fall further
drug for erectile dysfunction has been taken within the last 24 hours.
aortic or mitral stenosis

Question 5

Administration, Route, Dose

Answer 5

Spray under the tongue
Each spray delivering 0.4 mg doses

Myocardial ischaemia: 0.4 mg every 3-5 minutes.
Cardiogenic pulmonary oedema: 0.8 mg every 3-5 minutes
Autonomic dysreflexia: 0.4-0.8 mg every 3-5 minutes