Nitroglycerin

Question 0

Nitroglycerin, Route?

Answer 0

Sublingual

Spray or tablet

Question 1

Nitroglycerin, drug class?

Answer 1

Vasodilator

Question 2

Nitroglycerin, dose?

Answer 2

In adults, 1 spray (0.4mg) or 1 tablet (0.4mg) SL (sublingual)
May be repeated twice at 5 minute intervals as needed.
Can also repeat twice for pulmonary edema.

Question 3

Nitroglycerin, drug action?

Answer 3

Dilation of all systemic veins and arteries.
Decreases peripheral vascular resistance, preload/after load, cardiac workload/oxygen demand.
Dilation of coronary arteries.
*Note: Relieves anginal pain only, not pain of an AMI.

Question 4

Nitroglycerin, onset? Duration?

Answer 4

Onset: 1-3 minutes
Duration: 30 minutes - 1 hr

Question 5

Nitroglycerin, indications?

Answer 5

Chest pain (pressure, squeezing, crushing, heaviness, suffocation)
Pulmonary Edema (associated w/ CHF)

Question 6

Nitroglycerin, precautions?

Answer 6

A 12 lead must done to look for an inferior wall MI.
-If inferior wall MI is suspected, establish an IV prior to Nitro administration.
-Continue to monitor B/P and perfusion.
Pt should be sitting or lying down prior to.
Obtain a BP before and after each dose is given.

Question 7

Nitroglycerin, side effects?

Answer 7

Hypotension, Headache, Postural hypotension/syncope, reflex tachycardia, singing or bitterness under tongue.

Question 8

Nitroglycerin, Contraindications?

Answer 8

Systolic BP under 90, increased intracranial pressure, Viagra or Levitra used within the last 24 hrs or Cialis in the last 48 hours, Extreme bradycardias (less than 50), extreme tachycardias (more than 100), head injury