Nitroglycerin (Nitro-Stat)

Question 1

Nitroglycerin Class?

Answer 1

Nitrate, vasodilator

Question 2

Nitroglycerin Action?

Answer 2

Nitroglycerin is an organic nitrate and potent vasodilator. It relaxes vascular smooth
muscle resulting in coronary artery dilation while also reducing blood pressure, preload,
afterload, and myocardial oxygen demand.

Question 3

Nitroglycerin Indications?

Answer 3

Chest pain, acute coronary syndromes (ACS), pulmonary edema associated with
CHF, hypertensive emergencies

Question 4

Nitroglycerin Contraindications?

Answer 4

Hypersensitivity, pts that have taken erectile dysfunction drugs (Cialis,
Levitra, Viagra, etc.) within the last 24-72 hours, head injury, SBP < 100, cerebral stroke or
hemorrhage, extreme bradycardia or tachycardia, right ventricular infarction, volume
depletion.

Question 5

Nitroglycerin Onset/Duration?

Answer 5

Onset: 1-3 min
Duration: 25 min SL

Question 6

Nitroglycerin Dose/Route?

Answer 6

Adult: 0.4 mg SL, every 3-5 min up to three total doses for 1.2 mg

Peds: Not recommended in prehospital setting

Question 7

Nitroglycerin Side Effects?

Answer 7

Headache, hypotension, palpitations, dizziness, reflex tachycardia,
nausea/vomiting, postural syncope, diaphoresis.

Question 8

Nitroglycerin Note*

Answer 8

NTG must be kept in an airtight container and, if exposed to light, air or heat, it
decomposes which is why most pt’s own prescription doesn’t relieve their symptoms since pt’s
need to refill every 30 days if opened/used.