Nitroglycerin (NTG, Nitro)

Question 1

Nitroglycerin

Class:

Answer 1

Vasodialator

Question 2

Nitroglycerin

Action:

Answer 2

• Produces vasodilation by relaxing systemic venous & arterial vessels, thereby:
  
  • Decreasing preload & afterload
  • Decreasing myocardial workload
  • Decreasing myocardial O2 consumption
  • Dilates coronary arteries

Question 3

Nitroglycerin

Onset:

Answer 3

2 min

Question 4

Nitroglycerin

Duration:

Answer 4

30 - 60 minutes

Question 5

Nitroglycerin

Indications:

Answer 5

• Discomfort/pain suspected cardiac origin
• Respiratory distress: suspected CHF/ cardiac origin
• Hemodialysis: Fluid overload w/ Rales

Question 6

Nitroglycerin

Dosage/Route:
(For discomfort/pain suspected cardiac origin)

Answer 6

Adult only
If SBP > or = 100

0.4mg SL SO
MR q3-5 min SO

Question 7

Nitroglycerin

Dosage/Route:
(for respiratory distress suspected CHF/cardiac origin)

Answer 7

Adult only
If SBP > or = 100 but <150

0.4mg SL SO
MR q3-5 min SO

Question 8

Nitroglycerin

Dosage/Route:
(For hemodialysis: fluid overload w/ Rales)

Answer 8

Adult only
If BP > or = 150

0.8mg SL SO
MR q3-5 min SO

Question 9

Nitroglycerin

Contraindications:

Answer 9

• Patient who has taken an ED med within 48hr
• Patients taking med for Pulmonary Hypertension

Question 10

Nitroglycerin

Adverse Effects:

Answer 10

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

Question 11

Nitroglycerin

Packaging:

Answer 11

1 metered spray or 1 tablet = 0.4mg

Question 12

Nitroglycerin

Administration:

Answer 12

• Place Pt. in supine or semi-Fowler’s
• Start IV before or soon after first dose
• If tablet, place under tongue to dissolve
• If unable to spray under tongue, spray inside mouth (do not shake)

Question 13

Nitroglycerin

Cautions & Considerations:

Answer 13

• Will lower BP and increase orthostatic hypotension
• Continuously monitor HR and EKG
• Alcohol ingestion potentiates hypotension
• If Pt. becomes hypotensive, lay supine and consider fluid bolis
• Remove and wipe NTG patch/paste before defib.

Question 14

Nitroglycerin

Special info:

Answer 14

• NTG for ADULTS ONLY
• Document vitals and pain scale before and after each administration

NTG contraindicated due to a possible fatal drop in BP in Pt:
- Taken ED med such as: viagra, cialis, levitra within 48 hrs
- Taking pulmonary hypertension meds such as: Flolan, Revatio, Veletri