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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
- CP associated with angina pectoris or AMI
- Acute pulmonary edema
- Head trauma
- Patients in shock (systolic < 90mmHg)
- Patients with increased ICP
- 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
- Dry mouth
- Skin rash
May cause hypotension when used in conjunction with alcohol and antihypertensives (beta-blockers)
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
- 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)
- Onset = 1-3 mins SL, 30 mins TD
- Half-life = 1-4 mins
- 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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