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23 Cards in this Set
- Front
- Back
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Nitroglycerin (___, ___)
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NTG, NITRO
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Nitroglycerin Class
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Nitrate
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Nitroglycerin Action
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- Relaxes systemic venous & arterial vessels causing vasodilatation thereby:
= Decreases preload & afterload = Decreases myocardial workload = Decreases myocardial O2 consumption - Dilates coronary arteries |
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Nitroglycerin Onset
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- SL 2 min
- Topical 30-60 min |
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Nitroglycerin Duration
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- SL 30-60 min
- Topical 24 hours |
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Nitroglycerin Indication #1
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Pain or discomfort of suspected cardiac origin
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Nitroglycerin Dosage/Route #1
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If BP ≥ 100
- 0.4 mg SL; MR q 3-5" - Topical ointment / paste 1" If BP < 100 - 0.4 mg SL BHO; MR BHPO |
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Nitroglycerin Indication #2
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Respiratory distress ? CHF / cardiac origin
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Nitroglycerin Dosage/Route #2
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If BP ≥ 100
- Topical ointment / paste 1" If BP ≥ 100 but < 150 - 0.4 mg SL; MR q 3-5" If BP ≥ 150 - 0.8 ml SL; MR q 3-5" x 3; MR BHO If BP < 100 - 0.4 mg SL BHO; MR BHPO |
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Nitroglycerin Contraindications
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- Suspected intracranal bleed
- Patient who has taken a sexual enhancement medication such as Viagra / Cialis / Levitra within 48 hours |
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Nitroglycerin Side Effects
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- Orthostatic hypotension (can be profound)
- Temporary pulsating headache - Dizziness / syncope - Facial flushing - Reflex tachycardia |
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Nitroglycerin Concentration
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- Meter spray = 0.4 mg
- Ointment 1" = 15 mg |
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Nitroglycerin Special Information #1
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Nitroglycerin is used for ADULTS ONLY
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Nitroglycerin Special Information #2
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Check patient's BP before and after administration of each dose of NTG
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Nitroglycerin Special Information #3
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Preparing the patient for administration of NTG:
- Start an IV of NS, before or soon after first dose - Place patient in supine position, or if patient is sitting, elevate the legs. - If using tablet, place tablet under tongue and allow to dissolve - Spray inside mouth if unable to spray under tongue, is well absorbed - If patient becomes hypotensive, lay patient down and elevate legs |
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Nitroglycerin Special Information #4
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Remove existing NTG patch prior to use of your NTG
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Nitroglycerin Special Information #5
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Do not shake NTG spray
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Nitroglycerin Special Information #6
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Avoid application of dermal NTG to areas that may be used for cardioversion. Avoid irritated / broken skin.
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Nitroglycerin Special Information #7
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Tape patch to patient to prevent movement of paste.
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Nitroglycerin Special Information #8
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One inch of the dermal medication contains approximately 15 mg.
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Nitroglycerin Special Information #9
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If patient's chest pain is resolved / gone on medic arrival (self medicated with own NTG), continue treatment with NTG ointment and ASA
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Nitroglycerin Special Information #10
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Patients taking Silenadil/Levitra/Cialis or other medications for sexual enhancement may have a fatal drop in blood pressure of 50-60 mm Hg. Suspect patient may be on these medications if they have unexplained LOC. Half life of these medications is 4+ hours
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Nitroglycerin Special Information #11
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Assessing the effectiveness of NTG administration:
- Chest pain - question the patient regarding the status of the pain and recheck BP - CHF/pulmonary edema - reassess respiratory rate and effort, lung sounds, O2 saturation and BP |
