Nitroglycerin Flashcards
What is the recommended IV push dose range for Nitroglycerin?
A) 5-10 mcg
B) 10-20 mcg
C) 25-50 mcg
D) 100-200 mcg
B) 10-20 mcg
When preparing an IV solution from a 200 mcg/mL Nitroglycerin bottle, what should you do to achieve a concentration of 20 mcg/mL? Select 2:
A) Add 10 mL of NS to 2 mL of Nitroglycerin.
B) Add 18 mL of NS to 2 mL of Nitroglycerin.
C) Dilute the 200 mcg/mL concentration to a final volume of 20 mL.
D) Draw up 5 mL of Nitroglycerin and add 15 mL of NS.
B) Add 18 mL of NS to 2 mL of Nitroglycerin.
C) Dilute the 200 mcg/mL concentration to a final volume of 20 mL.
10-20 mcg push
20 mcg/mL concentration (2mL of Nitroglycerin bottle concentration 200mcg/mL and add to18mLNS)
Which of the following are true about the onset, peak, and duration of action (DOA) for Nitroglycerin? Select 3:
A) Onset is <1 minute
B) Peak effect occurs in 1-2 minutes
C) Duration of action is 5-10 minutes
D) Duration of action is 30-60 minutes
A) Onset is <1 minute
B) Peak effect occurs in 1-2 minutes
C) Duration of action is 5-10 minutes
What is the mechanism of action of Nitroglycerin?
Select 3:
A) Primarily a venous dilator, with some arteriolar dilation
B) Decreases venous return (VR) and preload
C) Acts as an alpha agonist, increasing vascular tone
D) Relaxes peripheral vascular smooth muscle by donating an NO group
A) Primarily a venous dilator, with some arteriolar dilation
B) Decreases venous return (VR) and preload
D) Relaxes peripheral vascular smooth muscle by donating an NO group
In which clinical scenarios is Nitroglycerin most beneficial?
Select 2:
A) Symptomatic coronary artery disease (CAD)
B) Hypertension (HTN) following coronary artery bypass grafting (CABG)
C) Pulmonary hypertension (HTN)
D) Hypotension due to hypovolemia
A) Symptomatic coronary artery disease (CAD)
B) Hypertension (HTN) following coronary artery bypass grafting (CABG)
For which conditions is Nitroglycerin contraindicated or not recommended?
Select 3:
A) Pulmonary hypertension
B) Hypertrophic obstructive cardiomyopathy (HOCM)
C) Severe aortic stenosis
D) Symptomatic coronary artery disease (CAD)
A) Pulmonary hypertension
B) Hypertrophic obstructive cardiomyopathy (HOCM)
C) Severe aortic stenosis
Which statements are correct regarding the pharmacokinetic and pharmacodynamic profile of Nitroglycerin?
Select all that apply:
A) Tolerance to Nitroglycerin can develop within 24 hours.
B) Nitroglycerin use can lead to methemoglobinemia.
C) Nitroglycerin has a half-life of 5 hours.
D) Nitroglycerin primarily affects arteriolar dilation.
A) Tolerance to Nitroglycerin can develop within 24 hours.
B) Nitroglycerin use can lead to methemoglobinemia.
In which patient populations is Nitroglycerin most useful?
Select 2:
A) Patients with symptomatic coronary artery disease (CAD)
B) Patients with hypertension (HTN) after coronary artery bypass grafting (CABG)
C) Patients with severe aortic stenosis
D) Patients with pulmonary hypertension
A) Patients with symptomatic coronary artery disease (CAD)
B) Patients with hypertension (HTN) after coronary artery bypass grafting (CABG)
In which conditions is Nitroglycerin NOT recommended?
Select 2:
A) Hypertrophic obstructive cardiomyopathy (HOCM)
B) Severe aortic stenosis
C) Hypertension post-CABG
D) Symptomatic CAD
A) Hypertrophic obstructive cardiomyopathy (HOCM)
B) Severe aortic stenosis
Why should Nitroglycerin be used with caution in patients with pulmonary hypertension?
Select 2:
A) It can elevate pulmonary vascular resistance.
B) It may increase afterload for the right heart, especially when coming off bypass.
C) It is likely to reduce right ventricular function by dilating the pulmonary artery.
D) It decreases systemic vascular resistance, worsening pulmonary HTN.
A) It can elevate pulmonary vascular resistance.
B) It may increase afterload for the right heart, especially when coming off bypass.
