Nitroglycerin (NTG)

Question 1

NTG: Generic Name

Answer 1

Nitrolingual (spray), Nitrostat (tabs), Nitro-Bid, Nitrol

Question 2

NTG: Trade Name

Answer 2

Nitroglycerin spray, tabs, paste

Question 3

NTG: Class

Answer 3

Vasodilator

Question 4

NTG: Actions

Answer 4

Cardiovascular effects:
Primary effect: vasodilation of coronary&cerebral arteries, cause following: ↑ coronary blood flow, ↓ work load/myocardial O2 demand, ↓ afterload, ↓ venous tone; cause blood pooling in peripheral veins, ↓ preload. Dilation of coronary arteries and relief of coronary artery spasm. Smooth muscle relaxant.

Question 5

NTG: Indications

Answer 5

Angina, CP suggestive of an AMI, pulmonary edema

Question 6

NTG: Contraindications

Answer 6

Hypotension, ED drugs in last 24-48h, cerebral bleeding, ↑ ICP.

Question 7

NTG: S.E.

Answer 7

HA, hypotension, syncope

Question 8

NTG: Supplied

Answer 8

Pump spray 400mcg (0.4mg) per spray (200 metered sprays). Tablets 0.4mg SL (1/150). Paste of 2% with measuring applicators for transdermal use.

Question 9

NTG: Adult Dose

Answer 9

Adult Only!
0.4mg tablet or one metered spray (.4mg) SL

1-2 inches (15-30mg) on the chest wall of NTG Paste.

May repeat same dose for CP and pulmonary edema pt q 5m x3 if SBP remains 90 or greater: 1.2mg SL (3 tablets). NO max dose.

Alternate Dose for Pulmonary Edema: (Protocol Based), based on SBP:
SBP 90-150: .4mg (1 tab)
SBP 150-200: .8mg (2 tabs)
SBP >200: 1.2mg (3 tabs)

Question 10

NTG: Precautions:

Answer 10

Do not shake aerosol spray container because this affects metered dose. Pt should sit or lie down.