Nitroglycerin

(Nitrostat, Nitrolingual)

Classification: 

Vasodilator

Action:             

Causes systemic dilation of the arteries and veins.

Decreases myocardial work load and O2 demand by reducing preload and afterload.

Increases myocardial perfusion by dilating coronary arteries.

Indications:              

Chest pain of suspected myocardial origin. Pulmonary

edema associated with cardiogenic shock.

Contraindications:

 Poor systemic perfusion (BP< 90)

 Use of Phosphodiesterase inhibitors (Viagra,

 Levitra (24 hours), Cialis (48 hours) etc.).

Patients with suspected cerebral hemorrhage.

Adverse Effects:

Cardiovascular

Hypotension

Bradycardia

chycardia     

Neurological

blurred vision

confusion

dizziness

headache

Gastrointestinal

nausea/vomiting

dry mouth

sublingual burning

General

flushed          

Administration:       

 0.4mg(1 spray) every 5 minutes SL (1.2mg max) 

Pediatric:  

          Not recommended 

Onset:                 

Duration:                  

Onset:                         1-3 minutes

Duration:                   30-60 minutes

Precautions:            

Monitor patient for onset of hypotension.

May have synergistic effect in patients taking beta blockers or calcium channel blockers.

Do not shake container, it will alter the dose delivered.