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Pt is complaining of chest pain. What drug to use?
What therapeutic effects does nitroglycerine have/give
- Primary pharmacologic effect is to relax smooth muscle
- Therefore, nitro can relax vascular smooth muscle, via vasodilation
- Provides pain relief in angina
- Through vasodilating action on peripheral vessels, promotes pooling of blood in systemic circulation and decreases resistance against which the heart has to pump
Indications for nitroglycerine
- Relieve pain of angina
- Also to treat pulmonary edema due to left heart failure
Contraindications for nitroglycerine
- DO NOT GIVE NITRO IF:
- Increased intracranial pressure
- Glaucoma, hypertension, hypoventilation
- Hiccups or epigastric distress w symptoms of AMI
- If pt is wearing nitro patch or paste, additional administration may be ineffective
Side effects to Nitroglycerine
- Transient throbbing headache (if no headache occurs, suspect nito is out of date and no longer potent)
- visual disturbances
How is nitroglycerin supplied?
- Ointment, tablets, sustained release capsules, spray or patches
- In field, tablets are perferred
Administration and dosage of nitroglycerine
- Sublingual administration.
- Pt should be semi-sitting or recumbent
- One 0.4 mg tab. sublingual
- May repeat every 5 mins to Max of 3 tablets
- Monitor BP no less than 90 systolic