Nitroglycerin

Question 1

Nitroglycerin Trade Name?

Answer 1

Nitrostat, Nitro-Bid

Question 2

Nitroglycerin Classification?

Answer 2

Nitrate

Question 3

Nitroglycerin Mechanism?

Answer 3

Is broken down to form Nitric Oxide (NO). Then, NO activates the conversion of GTP-cGMP + 2P in VSMCs. This activates a cascade of reactions that cause a reduction in intracellular Ca2+, VSMC relaxation (in arterioles) and decreased cardiac preload and afterload.

Question 4

Nitroglycerin Indications?

Answer 4

-ACS
-CHF/Pulmonary Edema

Question 5

Nitroglycerin Contraindications?

Answer 5

-Hypotension
-Hypovolemia
-Right ventricular (RV) infarction
-Erectile dysfunction medications taken in past 24-48 hours)

Question 6

Nitroglycerin Side Effects/Precautions?

Answer 6

• Hypotension
• Reflex tachycardia
• Syncope
• Nausea/vomiting
• Burning at absorption site
• Dry mouth

Question 7

Nitroglycerin Adult Dose?

Answer 7

ACS: 0.4 mg SL every 3-5 minutes; max 3 doses
CHF: 0.4-0.8 mg SL every 3-5 minutes
( 0.5-2.0 inches of transdermal NTG paste can be administered if SL NTG is effective)
IV infusion: Begin at 50 mcg/min; increase by 50 mcg/min every 3-5 minutes until desired effect; max 400 mcg/min

Question 8

Nitroglycerin Pediatric Dose?

Answer 8

Not Recommended

Question 9

Nitroglycerin Onset of Action?

Answer 9

1-3 minutes

Question 10

Nitroglycerin Duration of Action?

Answer 10

SL: 20-30 minutes. IV: 1-10 minutes

Question 11

Nitroglycerin Max Dose Adult/Pediatric?

Answer 11

ACS/SL: 1.2mg (3 doses)
CHF/SL: 2.4mg
IV: 400mcg/min

Question 12

Nitroglycerin Routes of Administration?

Answer 12

IV/IO/SL/Paste/Patch

Question 13

Nitroglycerin How Supplied?

Answer 13

• 0.4 mg sprays and tablets
• transdermal paste
• 200mcg/ml glassvials for IV infusion