Indications:
- Chest pain of cardiac origin
- Pulmonary edema associated with congestive heart failure (may be administered without an IV if systolic blood pressure > 110 mmHg)
Contraindications:
- stolic blood pressure less than 90 mm Hg
- Increased intracranial pressure
- Viagra® [sildenafil] or similar drugs (Cialis® [tadalafil], Levitra® [vardenafil]) in the previous 36 hours
- Hypersensitivity
Precautions:
- For acute coronary syndrome, 12-lead ECG 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
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:
BIOTEL AUTHORIZATION ONLY
1 spray (0.4 mg) or tablet
Route: Sublingual
Drug Action:
- Coronary and systemic vasodilator - decreases peripheral vascular resistance and preload
- Decreases cardiac workload and oxygen demand on the heart
Class: Vasodilator
Onset: 1 minute - 3 minutes
Duration: 30 minutes - 60 minutes