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To what class of drugs does nitroglycerin belong?
What indications are associated with nitroglycerin?
Acute heart failure
At what site is nitroglycerin absorbed?
Sublingual - a positional consideration - thsee blood vessels drain directly to the heart.
What is nitroglycerin's target MOA?
Nitroglycerin leads to NO, which stimulates guanylyl cyclase to produce cGMP. cGMP leads to the dephosphorylation of myosin light chain by myosin light chain phosphatase.
Tissue MOA: True or False?
Nitroglycerin relaxes arteriolar smooth muscle more greatly than venous smooth muscle.
Venous relaxation > arteriolar relaxation
Tissue MOA: what types of smooth muscle does nitroglycerin relax?
Venous, arteriolar, bronchial, and GI
Tissue MOA: how does nitroglycerin act as a platelet antiaggregate?
Dilation of blood vessels leads to decreased turbulence of blood flow, which decreases the likelihood of platelet aggregation.
Tissue MOA: how does nitroglycerin affect TPR (afterload) and venous return (preload)? What overall effect does this have?
TPR decreases as blood moves more easily into dilated veins.
Venous return decreases as blood pools in dilated veins.
Both lead to decreased BP.
What adverse effects are associated with nitroglycerin?
Orthostatic hypotension & syncope
HA, temporal artery pulsation
Tolerance (pts are advised to use nitro only in emergency situations)
It's way too late to switch out of pharmacy.