Nitroglycerin

Question 1

NITROGLYCERIN

Pharmacology & Actions

Answer 1

• Potent smooth muscle relaxant
• Causes systemic venodilation, decreasing preload
• Arterial vasodilation, decreasing afterload
• Coronary artery vasodilation
• Increases blood flow to the myocardium
• Decreases myocardial oxygen demand

Question 2

NITROGLYCERIN

Indications

Answer 2

• Chest pain, particularly when Acute Coronary Syndrome (ACS) is suspected
• Hypertensive emergency
• Congestive Heart Failure (CHF) with pulmonary edema

Question 3

NITROGLYCERIN

Absolute Contraindications

Answer 3

• Hypotension
• Recent use of erectile dysfunction medications (48 hours)
• Nitroglycerin is NOT TO BE GIVEN to children in prehospital setting
• Nitroglycerin allergy

Question 4

NITROGLYCERIN

Precautions & Side Effects

Answer 4

• Generalized vasodilation may cause profound hypotension and reflex tachycardia
• May cause profound hypotension in patients taking medication for erectile dysfunction
• Common side effects include throbbing headache, flushing, dizziness, and burning under the tongue
• Because nitroglycerin causes generalized smooth muscle relaxation, it may be effective in relieving chest pain caused by esophageal spasm

Question 5

NITROGLYCERIN

Administration

Answer 5

• SL (Sublingual)
• Onset: Immediate
• Peak Effect: 5-10min
• Duration: 20-30min