Nitroglycerin (Nitro-Dur)

Question 1

What are the classifications?

Answer 1

-Anti-Angina
-Vascular smooth-muscle relaxer
-Vasodilator?

Question 2

What are the Mechanisms of Action?

Answer 2

-Relaxes vascular smooth-muscle, dilating the veins and arterioles (at higher doses), causing blood pooling, which reduces the pre-load, decreasing the workload of the heart muscle.
-Reduces left ventricular systolic wall tension, which decreases the afterload

Question 3

What are its indications for use?

Answer 3

Possible ischemia due to ACS
-Unstable angina
-Acute Myocardial Infarction

-Pulmonary Edema/CHF (congestive heart failure)

Question 4

What contraindications does it have?

Answer 4

-Hypotension (<90mmHg)
-Severe bradycardia/tachycardia (<50 or >150 BPM)
-Increased ICP or Intracranial Hemorrhage
-Patients taking Erectile Dysfunction medications
-Viagra (within 24hrs)
-Cialis/Levitin/Staxyn
within 36hrs

Question 5

What are its doses?

Answer 5

0.4mg SL q 3-5min

Question 6

What side effects does it have?

Answer 6

-headaches
-hypotension
-bradycardia
-postural syncope (sudden drop in bp due to position change)
-weakness
-dizziness
-nausea/vomiting
-reflex tachycardia (heart beats faster than usual >100bpm)

Question 7

What are the precautions for this medication?

Answer 7

-Administration to Right Ventricular Infarction patients, due to preload dependency, can result in hypotension