Nitroglycerin

Nitroglycerin
(Nitrostat®. Nitrolingual® Spray)

CLASS

Vasodilator, Nitrate

DOSAGE

    Adult: 0.4 mg (1 tablet or 1 spary sublingual).
    May repeat in 3-5 minutes (no maximum as long as bp is above 110SBP ).

ACTIONS

    Nitroglycerin is a direct vasodilator, which acts principally on the venous system although it also produces direct coronary artery vasodilation as a result. There is a decrease in venous return, which decreases the workload on the heart and thus, decreases myocardial oxygen deman. Sublingual nitroglycerin is readily absorbed. Pain relief occurs within one to two minutes and therapeutic effects can last up to 30 minutes.

INDICATIONS

    - Chest pain or discomfort associated with suspected AMI or Angina Pectoris.
    - Pulmonary edema with hypertension.

CONTRAINDICATIONS

    - Patients increased intracranial pressure, systolic <110 mm Hg, children under 12.
    - Patients who have taken medication for erectile dysfuntion in the past 24 hours.

WARNINGS

    Tolerance to nitrates easily develops, which necessitates increasing the dosage. Nitroglycerin tablets are inactivated by light, heat, air and moisture. Must be kept in amber glass containers with tight-fitting lids. Do not leave cotton in container. Once opened, nitroglycerin has a shelf life of 3 months. Patients should keep all but a few days supply of the drug in the refrigerator. Do not shake Nitrolingual spray. Alcohol will accentuate vasodilating and hypotensive effects.

SIDE EFFECTS

    CNS: Headache, dizziness, flushing, nausea and vomiting.

    Cardiovascular: Hypotension, reflex tachycardia.

Nitroglycerin (Nitro-Bid® Ointment)

DOSAGE

    Adult:1 inch of 2% ointment topically for transdermal absorption.

ACTIONS

    Same as Nitrostat.

INDICATIONS

    Same as Nitrostat. Used when continued effects of Nitroglycerin are desired.

CONTRAINDICATIONS

    Same as Nitrostat.

WARNINGS

    Same as Nitrostat. In the event that the patient requires cardioversion or pacing, avoid placing paddles or defibrillator or pacing pads near Nitro patch. It may be necessary to remove Nitro patch and wipe off skin prior to placing paddles or patches before cardioversion or pacing.

SIDE EFFECTS

    Same as Nitrostat.
Last Modified: 03/30/2013 - 01:29