CPP Glyceryl Trinitrate (GTN)

Question 1

Glyceryl Trinitrate (GTN)

Presentations

Answer 1

a) 0.4mg Nitrolingual spray,

b) 0.6mg Anginine and Lycinate tablets (sublingual use only) (trade/brand names in Australia).

• Query use of Nitrostat 0.3mg or 0.6mg?

Question 2

Glyceryl Trinitrate (GTN)

Primary emergency indications

Answer 2

a) Cardiac chest pain,
b) Hypertension associated w ACPO,
c) Hypertension associated w ACS.

Question 3

Glyceryl Trinitrate (GTN)

Contraindications
(Known hypersensitivity plus)

Answer 3

a) Head trauma or haemorrhage,
b) Heart rate >150bpm or <50bmp,
c) Systolic BP <100mmHg,
d) VT,
e) Sildenafil and/or Vardenafil in prev 24hrs,
f) Tadalafil in prev 48hrs.

• Tadalafil (Cialis) may also be prescribed to men for treatment of Benign Prostatic Hypertrophy BPH.

Question 4

Glyceryl Trinitrate (GTN)

Precautions

Answer 4

a) No previous administration of GTN,
b) Elderly or frail patients,
c) Recent MI,
d) Concurrent use with tocolytics.

• Tocolytics are drugs that slow or stop contractions of uterine smooth muscle to delay preterm labor

Question 5

Glyceryl Trinitrate (GTN)

Key timings

Answer 5

Onset = 30sec - 2mins,
Peak = 3-5min,
Duration = 15-30min.

Question 6

Glyceryl Trinitrate (GTN)

Pharmacology/Actions

Answer 6

a) Vasodilation,
b) Reduced preload and afterload,
c) Reduced myocardial oxygen demand,
d) Reduced BP,
e) Mild tachycardia secondary to fall in BP.

Question 7

Glyceryl Trinitrate (GTN)

Side effects

Answer 7

a) HTN (HYPOtension?),
b) Tachycardia,
c) Headache,
d) Nausea and vomiting,
e) Syncope,
f) Dizziness.

Question 8

5 Rights of medication administration

Answer 8

1. Patient,
2. Medication,
3. Dose,
4. Time,
5. Route.

Question 9

When is a patient NOT NEPT suitable?

Answer 9

a) Cardiac chest pain within the last 2 hours,
b) Any cardiac chest pain that does NOT resolve with pts usual med(s),
c) Pt reqs an immed time crit tx (angiography or surgery).