MED-Nitroglycerin

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Author:
amerelman
ID:
22265
Filename:
MED-Nitroglycerin
Updated:
2010-06-06 10:17:18
Tags:
MED Nitroglycerin
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Description:
MED-Nitroglycerin
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  1. Functional Class
    Nitrate
  2. Mechanism of Action
    • Rapid vascular smooth muscle relaxant resulting in increased coronary blood flow and improved perfusion of myocardium
    • Results in decreased venous return to the heart, alleviation of CP, and decreased preload and afterload of left ventricle
  3. Indications
    • CP associated with angina pectoris or AMI
    • Acute pulmonary edema
    • CHF
  4. Contraindications
    • Hypersensitivity
    • Head trauma
    • Patients in shock (systolic < 90mmHg)
    • Patients with increased ICP
  5. Precautions
    • Protect from light and air
    • Monitor vitals closely for orthostatic hypotension
    • Posphodiesterase-type 5 (PDE-5) inhibitors:
    • Viagra: use within past 24 hours
    • Cialis: use within past 48 hours
    • Levitra: use within past 48 hours
  6. Side Effects
    • Hypotension
    • Palpitations
    • Tachycardia
    • Syncope
    • Dry mouth
    • N/V
    • Headache
    • Dizziness
    • Skin rash
  7. Interactions
    May cause hypotension when used in conjunction with alcohol and antihypertensives (beta-blockers)
  8. Dose and Route
    • 0.4 mg SL (or 1/150 gr) tablet or spray q 5 mins with BP >100 systolic
    • 1-2 inches of paste

    • Infusion:
    • 10 mcg/min IV infusion pump increasing 5-10 mcg/min q 5 mins to relieve CP or pulmonary edema
    • (if systolic BP >100 mmHg)
  9. Pharmacokinetics
    • Onset = 1-3 mins SL, 30 mins TD
    • Half-life = 1-4 mins
  10. Note
    • Recommend two IVs or twin-cath in place to administer infusion.
    • Do not shake aerosol spray as it may effect metered dose.

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