Nitroglycerin (NTG)

Question 1

Nitro: abbreviation

Answer 1

NTG or Nitro

Question 2

Nitro: Class

Answer 2

Vasodilator

Question 3

Nitro: Action

Answer 3

• Vasodilation by relaxing systemic venous and arterial vessels, thereby:
• Decreases PRELOAD and AFTERLOAD
• Decreases Myocardial workload, and
• Decreases myocardial 02 consumption
• Dilates coronary arteries

Question 4

Nitro: Onset/Duration

Answer 4

Onset: SL = 1-2 minutes; topical = 30-60 minutes

Duration: SL = 30-60 min; Topical= 24 hours

Question 5

Nitro: Indications

Answer 5

Discomfort/ Pain of ? CARDIAC origin

Fluid overload with rales
- Hemodialysis patients

Respiratory Distress
- CHF / cardiac origin ***

Question 6

Nitro: dosage/route for

Chest Pain

Answer 6

Adult Only:
If BP ≥ 100:
- .4 mg SL; MR q 3-5”
- Topical paste, 1 inch

If BP < 100
- .4 mg SL, BHO; MR BHPO!

Question 7

Nitro: dosage/route for

Fluid overload with Rales
Hemodialysis patient

Answer 7

Adult Only:
If BP ≥ 100:
    - Topical paste, 1 inch
If BP ≥ 100 but < 150
    - 0.4mg SL.   MR q 3-5”
If BP ≥150
    - 0.8mg  SL;   MR q 3-5”
If BP < 100
    - 0.4mg  SL  BHO.... MR  BHPO!

Question 8

Nitro: Dosage/Route for

Respiratory distress of ? CHF / cardiac origin

Answer 8

Adult Only:
If BP ≥ 100:
    - Topical paste, 1 inch
If BP ≥ 100 but < 150
    - 0.4mg SL.   MR q 3-5”
If BP ≥150
    - 0.8mg  SL;   MR q 3-5”
If BP < 100
    - 0.4mg  SL  BHO.... MR  BHPO!

Question 9

Nitro: contraindications

Answer 9

• Sexual enhancement drugs in past 48 hours
  (Viagra, Cialis, Levitra)
• Pulmonary Hypertension drugs in past 48 hours
  (Sildenafil: Revatio, Flolan, Veletri)

Question 10

Nitro: Side Effects

Answer 10

• Orthostatic hypotension
• Dizziness / syncope
• Temporary pulsating headache
• Facial flushing

Question 11

Nitro: Packaging

Answer 11

1 tablet (or 1 metered spray) = 0.4mg

1” of paste = 15mg

Question 12

Nitro: Cautions and Considerations

Answer 12

• if patient becomes hypotensive, lay supine and consider fluids
• Remove any existing patches from patient
• continue treatment even if patient has taken own nitro and symptoms subside prior to arrival