Terry White, RN, EMT-P 1

NITROGLYCERIN

Terry White, RN, EMT-P 2

Nitroglycerin

• Indications–Ischemic Chest Pain

Terry White, RN, EMT-P 3

Nitroglycerin

• Contraindications–BP<100mm Hg

–Pt. Has already taken maximum dose of three doses (1.2mg)

Terry White, RN, EMT-P 4

Nitroglycerin• Dose

–.4mg sublingual

•Tablet or Metered-dose Spray

–.4mg Trans-dermal patch

–May repeat at 5 minute intervals up to 3 doses (1.2mg)

Terry White, RN, EMT-P 5

Nitroglycerin

• Mechanism of Action–Relaxes vascular smooth muscle

Terry White, RN, EMT-P 6

Nitroglycerin

• Effects–Decreased pre-load

–Decreased after-load

–Increased blood flow to Ischemic Myocardium

Terry White, RN, EMT-P 7

Nitroglycerin

• Side Effects–Hypotension

–Reflex Tachycardia

–Headache

Terry White, RN, EMT-P 8

Nitroglycerin• Comments

–Most effective when Pt is sitting

–If tablet form - Protect potency• Store in original brown bottle

• Keep tightly sealed

• Protect from light, air, heat

• Secure new supply every 4 - 6 months

Terry White, RN, EMT-P 9

Nitroglycerin

• Potent Nitroglycerin–Headache

–Burning sensation under tongue