Nitrates

Question 1

mechanism of action

Answer 1

convert to nitric oxide
relax muscle around the vessel = vasodilation
mainly veins

Question 2

resistance concerns

Answer 2

minimize the risk by having at least 8 hours of no drug in system, this allows substances that convert drug to nitric oxide to replenish
called hacky phalaxis= resistance
8 hours no drug = till drug wears off + 8 hours

Question 3

async dosing

Answer 3

do not follow BID, TID, QID

Question 4

sublingual NTG

Answer 4

do not swallow
need saliva
often tingling (if someone who often notices tingling doesn’t notice it that could mean it lost potency)

Question 5

storage, handling, administration of nitroglycerin

Answer 5

cool dark dry place
amber glass vials
sensitive to light, humidity, temp and plastic
do not take more than 3 doses
(1 does, wait 5 min, 2 dose, wait 5 mins, 3 dose, ER)
once bottle is opened replace every 3 months

Question 6

adverse effects

Answer 6

headache, flushing, orthostatic hypotension, reflex tachy

Question 7

hydralazine

Answer 7

not a nitrate, vasodilatior, precursor to nitric oxide

*only approved for African americans
alternative for ACEI/ARBs

Question 8

drugs

Answer 8

nitroglycerine
hydralazine
isosorbide mononitrate