Nitroglycerine

Question 1

Nitroglycerine

Class

Answer 1

• Vasodilator

Question 2

Nitroglycerine

MOA

Answer 2

• Smooth muscle relaxant acting on vascular, bronchial, uterine & intestinal smooth muscles
• Dilation of arterioles and veins in periphery
• Reduces preload and afterload
• Decreases workload on heart which reduces myocardial O2 demand

Question 3

Nitroglycerine

Indications

Answer 3

• Acute angina
• Ischemic chest pain
• HTN
• CHF
• Pulmonary edema

Question 4

Nitroglycerine

Contraindications

Answer 4

• Hypotension
• Hypovolemia
• Intracranial bleeding or head injury
• In last 24 hrs pt took:
  
  • Viagra (sildenafil citrate)
  • Revatio
  • Levitra (vardenafil)
  • Cialis (tadalafil)

Question 5

Nitroglycerine

Adverse reactions

Answer 5

• Hypotension
• Syncope
• HA
• N/V
• Diaphoresis
• Flushing
• Muscle twitching
• Reflex tachycardia

Question 6

Nitroglycerine

Drug interactions

Answer 6

• Additive effects with other vasodilators
• Incompatible in IV with other drugs

Question 7

Nitroglycerine

Dosage

Answer 7

Tablets: 0.3-0.4 mg SL, q 3-5 min, max of 3 doses

Spray: 0.4 mg SL, 1-2 sprays

Infusion:

• begin at 10-20 µg/min
• increase by 5-10 µg/min q 5 min until desired effect reached

Not for peds

Question 8

Nitroglycerine

Duration of action

Answer 8

• Onset: 1-3 min
• **Peak: ** 5-10 min
• Duration: 20-30 min
  
  • or if IV, 1-10min after discontinuation of infusion

Question 9

Nitroglycerine

Special considerations

Answer 9

• Preg Cat: C
• Hypotension more common in geriatric population
• Decomposes when exposed to heat or light
• Keep in airtight container
• Stinging effect