nitroglycerin.txt

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Author:
papeirce
ID:
76968
Filename:
nitroglycerin.txt
Updated:
2011-04-03 13:00:52
Tags:
paramedic medications drugs prehospital nitroglycerin
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Prehospital Medication Flashcards for Paramedic School - Massachusetts and Rhode Island
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  1. Nitroglycerin

    Trade Name
    • Nitrostat®
    • Nitro-Bid®
    • Tridil®
    • Nitrolingual®
  2. Nitroglycerin

    Class
    Vasodilators
  3. Nitroglycerin

    Mechanism of Action
    • Smooth muscle relaxant acting on vascular, bronchial, uterine and intestinal smooth muscle.
    • Dilation of arterioles and veins in the periphery
    • Reduces preload and afterload
    • Decreases the work load of the heart
    • Decreases myocardial oxygen demand
  4. Nitroglycerin

    Indications
    • Acute angina pectoris
    • Ischemic chest pain
    • Hypertension
    • Congestive Heart Failure (CHF)
    • Pulmonary edema
  5. Nitroglycerin

    Contraindications
    • Hypotension
    • Hypovolemia
    • Intracranial bleeding or head injury
    • Patients who have taken any of the following phosphodiesterase inhibitor medications within the last 48 hours should not receive NTG:
    • Sildenafil (Viagra®)
    • Vardenafil (Levitra®)
    • Tadalafil (Cialis®)
  6. Nitroglycerin

    Adverse Reactions
    • Headache
    • Hypotension
    • Syncope
    • Reflex tachycardia
    • Flushing
    • Nausea
    • Vomiting
    • Diaphoresis
    • Muscle twitching
  7. Nitroglycerin

    Drug Interactions
    • Additive effects with other vasodilators
    • Incompatible with other drugs IV
    • Patients who have taken any of the following phosphodiesterase inhibitor medications within the last 48 hours should not receive NTG:
    • Sildenafil (Viagra®)
    • Vardenafil (Levitra®)
    • Tadalafil (Cialis®)
  8. Nitroglycerin

    How Supplied
    • Tablets: 0.15 mg (1/400 grain); 0.3 mg (1/200 grain);
    • 0.4 mg (1/150 grain); 0.6 mg (1/100 grain)
    • Spray: 0.4 mg -0.8 mg under the tongue
    • Paste: 1 g packets or 30, 60 g tubes
    • IV: 25 mg in 250 NS yield 100mcg/ml
  9. Nitroglycerin

    Dosage and Administration
    Adult
    • Tablets: 0.3 -0.4 mg SL
    • Spray: 0.4 mg /1 spray SL may repeat in 3-5 minutes to maximum of 3 doses.
    • NTG Paste: 1 inch (1 5 mg) placed on anterior chest
    • NTG IV infusion: 25 mg in 250 NS yield 100mcg/ml Run @ 10mcg / min.; increase by 10 mcg / min. every 5 minutes until desired effect or max 300 mcg/min.
  10. Nitroglycerin

    Dosage and Administration
    Pediatric
    Not recommended
  11. Nitroglycerin

    Duration of Action
    • Onset: 1-3 minutes
    • Peak effect: 5-10 minutes
    • Duration: 20-30 minutes or. if IV, 1-10 minutes after discontinuation of infusion
  12. Nitroglycerin

    Special Considerations
    • Pregnancy Safety: Category C
    • Use with caution if inferior, posterior, right sided STEMI is suspected
    • Hypotension more common in geriatric population
    • NTG decomposes if exposed to light or heat
    • Must be kept in airtight containers
    • Active ingredient may have a stinging effect when administered SL

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