Nitroglycerin

Question 1

Nitroglycerin- Name

Answer 1

Nitrolingual

Nitrostat

Nitrobid

Tridil

Question 2

Nitroglycerin- Class

Answer 2

Vasodilator

Nitrate

Antianginal

Question 3

Nitroglycerin- MoA

Answer 3

Relaxes smooth muscles causing venous dilation

Reduces preload and afterload to the heart

Dilates the coronary arteries resulting in increased perfusion of the myocardium

Question 4

Nitroglycerin- Indications

Answer 4

Chest pain of cardiac origin

Acute pulmonary edema

Question 5

Nitroglycerin- Contra

Answer 5

Blood pressure less than 90 mmHg systolic

Patients who have taken Erectile Dysfunction (PDE5 inhibitors) medications in the last 24-48 hours

Signs and symptoms of head trauma (increased intracranial pressure) or cerebral hemorrhage

Poor systemic perfusion

Question 6

Nitroglycerin- S/E

Answer 6

Cardiovascular: hypotension, bradycardia, rebound hypertension/tachycardia, palpitations

Neurological: headache

Other: flushed skin, sublingual burning

Question 7

Nitroglycerin- Routes

Answer 7

SL, TM (transmucosal), transdermal (nitropaste)

Question 8

Nitroglycerin- A. Dose

Answer 8

0.4 mg as a single spray or single tablet.

May repeat every 3-5 minutes

Nitropaste is 15 mg per one inch, multi dose tube

1 gm single dose patch

Question 9

Nitroglycerin- P. Dose

Answer 9

not recommended

Question 10

Nitroglycerin- EXTRAS

Answer 10

Precautions: Monitor blood pressure closely for signs of hypotension (before and after administration)

Interactions: Use with caution with patients who already use vasodilators, alcohol, calcium channel blockers, beta blockers and phenothiazides

Onset in 1-3 minutes and may last 30-60 minutes

Do not shake canister if administered as a spray as it will altered the metered dose in a single spray

Do not have patient inhale drug on administration as it will alter absorption rate

Establish IV prior to or immediately following administration to combat hypotension if necessary