4.4 Nitrates

Question 1

The function of nitrates is…

Answer 1

Vasodilation of coronary arteries, although they dilate all blood vessels

Question 2

2 types of nitrates include:

Answer 2

Nitroglycerin
Isosorbide dinitrate

Question 3

Nitrates are available in which forms?

Answer 3

• Sublingual, tablets, spray
• Oral capsules/tablets
• Intravenous solutions
• Ointments
• Transdermal patches, NTG patches (transdermal) varying doses 0.2-0.4 - 0.6-0.8mg/hr on/off 12 hours to reduce tolerance
• Buccal

Question 4

Indications for the use of nitrates include…

Answer 4

• To reduce oxygen demand
• Coronary artery spasm
• Atherosclerosis
• Exercise induced constriction

Question 5

The main contraindications for the use of nitrates are…

Answer 5

• Allergy
• severe anemia
• closed-angle glaucoma
• hypotension
• severe head injury

Question 6

Isosorbide dinitrate is used for…

Answer 6

Acute relief of angina
Acute and Long-term prophylaxis

Question 7

Side effects of isosorbide dinitrate include…

Answer 7

• Headache
• Tachycardia
• Postural hypotension
• Tolerance may develop

*Same as nitroglycerine

Question 8

Nitroglycerine has a _____ first pass effect

Answer 8

Large

Question 9

Nitroglycerine is used for…

Answer 9

• The symptomatic treatment of angina
• The control of BP postoperatively
• Other critical situations

Question 10

Side effects of nitroglycerine include…

Answer 10

• Headache
• Tachycardia
• Postural hypotension
• Tolerance may develop

*Same as nitroglycerine

Question 11

What is the proper technique for the sublingual application of nitroglycerine?

Answer 11

Never chew/swallow SL preparation
May experience burning sensation at SL site

Question 12

Nitroglycerine has a ____ shelf life of about ___ months.

Answer 12

short, 3 months

Question 13

Nitroglycerine should be stores under what conditions?

Answer 13

dark, airtight space

Question 14

What is the proper technique for the transdermal application of nitroglycerine?

Answer 14

-Site rotation
- Removal and disposal of used medication
*remove HS and reapply in am (tolerance)

Question 15

IV forms of nitroglycerine must be contained in
_____ IV bottles and must be given with infusion pumps

Answer 15

glass

Question 16

What are the 3 steps clients should follow when taking nitroglycerine?

Answer 16

• Take at first sign of angina (heart pain)
• Repeat q5min if no relief (max 3)
• If persists – seek medical attention – do not drive – 911

Question 17

T/F, nitroglycerine should be exposed to heat and direct light

Answer 17

False

Question 18

Alcohol consumption, hot baths, whirlpools, etc cause what when combined with anti-anginals?

Answer 18

Hypotension, can lead to fainting

Question 19

Why should a client on anti-anginals change position slowly?

Answer 19

There is a risk of postural hypotension

Question 20

Clients should keep a record of anginal attacks, including…

Answer 20

• Precipitating factors
• # NG taken
• Therapeutic effects