Nitroglycerin (Nitrostat) Flashcards

1
Q

Drug Classification

A

Vasodilator/Nitrate

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2
Q

Mechanism of Action

A

Nitroglycerin is a pro-drug, which must be de-nitrated to form the active metabolite nitric oxide (NO). Then, NO activates the conversion of GTP ->cGMP+2Pi in VSMC. cGMP activates a cascade of reactions that cause a reduction in intracellular Ca2+ ->VSMC relaxation (in arterioles) and decreased cardiac preload and after load.

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3
Q

Pharmacokinetics

  • Onset of Action
  • Peak Effects
  • Duration of Effects
  • Half Life
A
  • Onset of Action- 1-2minutes IV, 1-3minutes SL, 30 minutes topical
  • Peak Effects- 5-10minutes SL, varies topical
  • Duration of Effects- 20-30minutes SL, 3-6hours topical
  • Half Life- 1-4 minutes
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4
Q

Indications/Field Use

A
  • Chest Pain associated with angina or MI

- Acute Pulmonary Edema/CHF

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5
Q

Contraindications

A
  • Shock/Hypotension
  • Increased ICP
  • Children under 12
  • ED drugs within 48 hours
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6
Q

Side Effects/Adverse Reactions

A

HA, dizziness, tachycardia, hypotension, rash, dry mouth, N&V

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7
Q

Dose

A

Adult:
Spray- 0.4mg SL q3-5 minutes until effect achieved or b/p drops (max 3x25min)
Paste- 1/2-1 inch topical
Tablet- 0.4mg SL q3-5 minutes until effect achieved or b/p drop (max 3x25min)

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8
Q

Precautions

A
  • Expect HA from cerebral vasodilation
  • Routine use may cause tolerance
  • 12 lead ECG prior to administration - use extreme caution if R side MI
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9
Q

Drug-Drug interactions

A

Orthostatic(dizzy when standing) hypotension with B blockers, severe hypotension with alcohol

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