NITROGLYCERIN (Nitrostat®) Flashcards
Generic/Trade Name
NITROGLYCERIN
Nitrostat®
Generic/Trade Name
Nitrostat®
NITROGLYCERIN
NITROGLYCERIN (Nitrostat®)
Drug Classification:
Vasodilator
Nitrate
NITROGLYCERIN (Nitrostat®)
Mechanism of Action:
Pro-drug which must be de-nitrated to form the activemetabolite nitric oxide (NO).
NO activates the conversion of GTP ⇒ cGMP + 2Pi in vascular smooth muscle cells (VSMC).
cGMP activates a cascade of reactions that cause a reduction in intracellular Ca2+, VSMC relaxation (in arterioles) and decreased cardiac preload and afterload.
(causes reduction of intracellular Ca2+⇒VSMC relaxation (vasodilation) (in arterioles) and decrease of cardiac preload/afterload)
NITROGLYCERIN (Nitrostat®)
Pharmacokinetics
- Onset of Action = 1-2 minutes IV, 1-3 minutes SL, 30 minutes topical
- Peak Effects = 5-10 minutes SL, varies topical
- Duration of Effect = 20-30 minutes SL, 3-6 hours topical
- Half-Life = 1-4 minutes
NITROGLYCERIN (Nitrostat®)
Indications & Contraindications
Indications/Field Use:
• Chest pain associated with angina or MI
• Acute pulmonary edema/CHF
Contraindications:
• Shock, hypotension
• Increased ICP
• Children under 12
• ED drugs w/in 48 hours
NITROGLYCERIN (Nitrostat®)
Side Effects/Adverse Reactions:
HA, dizziness, weakness, N+V
tachycardia, hypotension
rash, dry mouth
NITROGLYCERIN (Nitrostat®)
Adult & Pedi Dose:
Spray (ADULT): 0.4mg SL q3-5min until effect achieved or BP drops (max 3x25min)
Paste (ADULT): 0.5-1 inch Topical
Tablet (ADULT): 0.4mg SL
NITROGLYCERIN (Nitrostat®)
Precautions:
- Monitor vitals
- expect HA from cerebral vasodilation
- routine use may cause tolerance
- 12-lead ECG prior to administration – use extreme caution if R-side MI
NITROGLYCERIN (Nitrostat®)
Drug-Drug Interactions:
Orthostatic hypotension with β-blockers
Severe hypotension with alcohol
