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Used in the management of chest pain associated with both Angina and AMI. Nitroglycerin is available in an aersol preparation that delivers exactly 0.4mg in each spary with a peak effect in two to four minutes, in 0.4mg sublingual tablets, and as a transdermal topical ointment.
Mechanism of Action
NTG is a rapid smooth muscle relaxant that causes decreased cardiac work; Dilates both arterial and venous vessels and causes venous pooloing of blood; Causes vasodilation of coronary arteries, thus increasing perfusion of ischemic myocardium; Pain relief occurs within two minutes and therapeutic effects can be observed up tp 30 minutes later.
Chest pain associated with agina pectoris; Chest pain associated with acute myocardial infarction; acute pulmonary edema
NTG is contraindicated in patients with increased ICP
It may induce headaches-from vasodilation of cerebral vesseles patients may develop a tolerance; avoid contamination of tip. Wipe off tip with alochol prep should it come in contact with patient's mouth or body fluids.
Dosage and Administration
1 spray (0.4 mg) under tounge every 5 minutes until chest pain is resolved or the patient's systolic blood pressure goes below 100mmHg, OR 1 spray (0.4 mg) under the tounge, then administer a second SL spray 5 minutes after the first spray. Continue the therapy until chest pain is resolved or the patient's systolic blood pressure goes below 100mmHg.
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