GTN spray

Question 1

Preperation

Answer 1

Metered dose bottle delivering 0.4mg per spray

Question 2

Indications

Answer 2

“Mary Cameron Can’t Actually speak Fluent Italian” Myocardial ischemia, CPO, Control of hypertension: Autonomic Dsyreflexia, prior to Fibronoylisis for STEMI (usually in conjunction with labetalol or metropolol), during Interhospital transfer of STEMI (usually in conjunction with labetalol or metropolol).

Question 3

Contraindications

Answer 3

“Annie Baker Hates Vegetables” Severe allergy, systolic Blood pressure less than 100mgHg, HR less than 40 and greater than 150, Ventricular Tachycardia.

Question 4

Cautions

Answer 4

“Dylan Ditched Some Small Puppies” Drug for erectile dysfunctions taken within 24 hours, Dsyrthymia, STEMI especially of RV, mirtal/ aoritic Stenosis, Pt frail/ physiologically unstable.

Question 5

Action

Answer 5

Causes the formation of nitric oxide a vasodilator that acts on vascular smooth muscle to cause venous and arterial vasodilation resulting in the reduction of myocardium demand for oxygen.

This is because the reduction of preload reduces ventricular filling and CO.

And reduction in afterload hence reducing the force the left ventricular must overcome to eject blood from the heart.

Question 6

Route

Answer 6

Sublingual

Question 7

Dose

Answer 7

Myocardial ischemia: 0.4mg ever 3-5 minutes
CPO: 0.8mg every 3-5 minutes, increase dose interval and frequency if pt not improving.
Control of hypertension: 0.4-0.8mg every 3-5 minutes.
If a caution is present decrease dose interval to every 10m minutes.

Question 8

Side effects

Answer 8

“Happy Doesn’t Trust the Feds”

Hypotension, Headache, Dizziness, Tachycardia, Flushed.