| Class: |
Vasodilator |
| Route: |
Sublingual |
Adult Dose: |
- Standing order
- 1 spray (0.4 mg) or tablet - standing order
- May repeat twice at 5 minute intervals PRN - standing order
- BioTel must authorize additional doses beyond the initial three
|
| Pediatric Dose: |
1 spray (0.4 mg) or tablet - BIOTEL AUTHORIZATION ONLY |
| Drug Action: |
- Coronary and systemic vasodilator - decreases peripheral vascular resistance and
preload
- Decreases cardiac workload and oxygen demand on the heart
|
| Onset: |
1 minute - 3 minutes |
| Duration: |
30 minutes - 60 minutes |
| Indications: |
- Chest pain of cardiac origin
- Pulmonary edema associated with congestive heart failure (may be administeredwithout an IV if systolic blood pressure > 110 mmHg)
|
| Precautions: |
- For acute coronary syndrome, 12-lead must be performed prior to nitroglycerin administration
- Monitor blood pressure closely. If blood pressure falls below 110 mmHg resulting from nitroglycerin administration, DO NOT give any additional nitroglycerin.
- Assure patient is sitting or lying down during administration
- Active ingredient of nitroglycerin will “sting” when administered sublingually
- IV must be established prior to administration in patients with suspected inferior wall MI
|
| Side Effects: |
- Hypotension
- Headache
- Postural hypotension/syncope
- Reflex tachycardia
- Nausea and vomiting
- Diaphoresis
|
| Contraindications: |
- Systolic blood pressure <110 mmHg
- Increased intracranial pressure
- Viagra® [sildenafil] or similar drugs (Cialis® [tadalafil], Levitra® [vardenafil]) in the previous 24 hours
- Hypersensitivity
|