Nitroglycerin

Question 1

Other name

Answer 1

Nitrostat

Question 2

Classes

Answer 2

Nitrate

Antianginal

Question 3

Actions

Answer 3

Reduces smooth muscle spasms of GI disorders.
Dilates large coronary arteries, antagonizes vasospasm, and increases coronary collateral blood flow to the ischemic myocardium.
Relaxes vascular smooth muscle leading to marked venodilation which decreases preload, which in turn decreases intramyocardial wall tension, and mild to moderate arterial dilation which decreases afterload, which both lead to a decrease in myocardial oxygen demand.

Question 4

Indications

Answer 4

Angina pectoria
AMI
Acute hypertension
Acute pulmonary edema

Question 5

Contraindications

Answer 5

Hypotension (<100mmHg per hawaii standing orders).
RVI (inferior with hypotension)
Allergy to nitrates
Use of phosphodiesterase inhibitors for ED (sildenafil, vardenafil at 24hrs, and tadalafil for 72 hours)

Question 6

Side effects

Answer 6

HA
Dizziness
Flushing
Syncope
Reflex tachycardia
Weakness
Hypotension
Stinging upon contact with mucous membranes

Question 7

Precautions

Answer 7

Monitor bp and check if drug dissolved
Store in a cool dry dark place as poor storage can shorten expiration date.
Nitroglycerine induced hypotension typically responds well to supine position and then fluid administration, since therapeutic effects are more a function intravascular volume status than dose.
Ed drugs promote hypotension.
Have pt sit up to help decrease preload during administration.
Have pt open mouth and lift tongue prior to administration.