Nitroglycerin (NTG) Flashcards Preview

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Flashcards in Nitroglycerin (NTG) Deck (10)
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1

Nitroglycerin (NTG): Classification

1. Antianginal

2. Nitrate

2

Nitroglycerin (NTG): Pharmacodynamic

1. Relaxes vascular smooth muscle

2. Nitric oxide in vascular endothelial cells causes formation of cyclic guanosine monophosphate (c-GMP) which inactivates myosin light-chain kinase or stimulates dephosphorelation of myosin phosphate

3. Causes decreased preload and decreased MVO2 (myocardial oxygen consumption)

3

Nitroglycerin (NTG): Pharmacokinetics

1. Sublingual
- Onset: 1-3 minutes
- Peak: Unknown
- Half-life: 1-4 minutes
- Duration: 30 minutes

4

Nitroglycerin (NTG): Indications

1. Chest discomfort of suspected cardiac ischemic origin

2. Cardiogenic acute pulmonary edema

5

Nitroglycerin (NTG): Contraindications

1. Allergy or known hypersensitivity to NTG or other nitrates

2. Viagra or Levitra in last 24 hours

3. Cialis in last 48 hours

4. Hypotension or uncorrected hypovolemia

5. Severe anemia

6. Constrictive pericarditis and pericardial tamponade

7. Inferior MI on 12 lead ECG

6

Nitroglycerin (NTG): Relative Contraindications

1. Open or closed angle glaucoma

7

Nitroglycerin (NTG): Precautions

1. Use with caution in presence of hepatic or renal insufficiency

2. Patients on concurrent anti-hypertensive therapy

8

Nitroglycerin (NTG): Adverse Effects

1. Hypotension - do not administer if blood pressure is <90 systolic or patient exhibits signs of significant hypoperfusion headache, N/V

9

Nitroglycerin (NTG): Drug to Drug interaction

1. Alcohol and nitroglycerin may have additive vasodilator effects that may lead to hypotension

10

Nitroglycerin (NTG): Dosage

1. 0.4 mg spray SL - repeat q 3 min - maintaining B/P > 90 systolic

2. Infusion: 10 - 200 ug/min (in hospital)