Nitroglycerin Drug Card for Paramedics

Questions and Answers

What is the Trade Name for Nitroglycerin?

Nitrostat, Nitro-Bid, Tridil.

What Class is Nitroglycerin in?

Vasodilator.

What is Nitroglycerin's Mechanism Of Action?

Smooth Muscle Relaxant acting on Vasculature, Bronchial, Uterine, Intestinal Smooth Muscle. It dilates arterioles and veins in the periphery, reducing preload and afterload, thereby decreasing workload of the heart and myocardial oxygen demand.

What are the Indications for Nitroglycerin?

Acute Angina Pectoris, Ischemic Chest Pain, Hypertension, CHF, Pulmonary Edema. Signup and view all the answers

What are the Contraindications for Nitroglycerin?

Hypotension, Hypovolemia, Intracranial bleeding or head injury, Pericardial tamponade, Severe bradycardia or tachycardia, RV infarction, Previous administration in last 24 hours of Cialis (tadalafil 48 hours), Levitra, Viagra. Signup and view all the answers

What are the Adverse Reactions/Side Effects of Nitroglycerin?

Headache, Dizziness, Weakness, Reflex Tachycardia, Syncope, Hypotension, Nausea, Vomiting, Dry Mouth, Muscle Twitching, Diaphoresis. Signup and view all the answers

What are the Drug Interactions for Nitroglycerin?

Additive effects with other vasodilators and incompatible with other drugs IV. Signup and view all the answers

How is Nitroglycerin Supplied?

Tablets of 0.3 mg, 0.4 mg, and 0.6 mg. NGT Spray of 0.4 mg/actuation. NTG IV (Tridil) 200 ug/mL in D5W glass vials. Signup and view all the answers

What is the Dosage and Administration of Nitroglycerin for Adults?

Tablet is 0.3-0.4 mg sublingually; may repeat in 5 minutes to a maximum of 3 doses. NTG Spray is 1-2 sprays for 0.5-1 second at 5-minute intervals to a maximum of 3 sprays in 15 minutes. NTG IV infusion begins at 10 ug/min; increase by 10 ug/min every 3-5 min until desired effect, to a maximum of 200 ug/min. Signup and view all the answers

What is the onset and duration of Nitroglycerin?

Onset is 1-3 minutes, peak effect is 5-10 minutes, duration sublingually is 20-30 minutes, and duration IV is 1-10 minutes after discontinuation of infusion. Signup and view all the answers

What are the Special Considerations for Nitroglycerin?

Pregnancy Safety: Category C. Hypotension is more common in the elderly. Rule out right ventricular infarct before administration if inferior wall infarct is shown on ECG. Must be kept in airtight containers. Administer only with an infusion pump direct from the bottle with a vented IV set and non-PVC tubing. Signup and view all the answers

Study Notes

Trade Names

Nitroglycerin is known by three trade names: Nitrostat, Nitro-Bid, and Tridil.

Classification

Classified as a Vasodilator.

Mechanism of Action

Acts as a smooth muscle relaxant targeting vasculature, bronchial, uterine, and intestinal smooth muscle.
Dilates arterioles and veins, reducing preload and afterload.
Decreases heart workload and myocardial oxygen demand.

Indications

Utilized for acute angina pectoris, ischemic chest pain, hypertension, congestive heart failure (CHF), and pulmonary edema.

Contraindications

Should not be administered in cases of hypotension, hypovolemia, intracranial bleeding or head injury, pericardial tamponade, severe bradycardia or tachycardia, right ventricular infarction.
Avoid use if administering within 24 hours of Cialis (tadalafil), Levitra, or 48 hours of Viagra.

Adverse Reactions/Side Effects

Common side effects include headache, dizziness, weakness, reflex tachycardia, syncope, hypotension, nausea, vomiting, dry mouth, muscle twitching, and diaphoresis.

Drug Interactions

May have additive effects with other vasodilators.
Incompatible with other IV medications.

Supply Forms

Available in tablet forms of 0.3 mg, 0.4 mg, and 0.6 mg.
NGT spray contains 0.4 mg per actuation.
NTG IV (Tridil) is supplied in 200 µg/mL concentration in D5W glass vials.

Dosage and Administration for Adults

Sublingual tablets: 0.3-0.4 mg; repeat every 5 minutes, max 3 doses.
NGT spray: 1-2 sprays (0.5-1 second) at 5-minute intervals, max of 3 sprays in 15 minutes.
NTG IV infusion: start at 10 µg/min, increase by 10 µg/min every 3-5 minutes to a max of 200 µg/min.

Onset, Peak, and Duration

Onset time is 1-3 minutes; peak effect occurs in 5-10 minutes.
Duration for sublingual administration is 20-30 minutes; duration for IV is 1-10 minutes post-infusion discontinuation.

Special Considerations

Pregnancy Category C.
Hypotension risk is higher in the elderly.
Inferior wall infarct on ECG should be checked for right ventricular infarct before administering.
Store nitroglycerin in airtight containers.
Administer using an infusion pump with a vented IV set and non-PVC tubing.
Active ingredients may have a stinging sensation upon administration.

Description

This quiz covers essential information about Nitroglycerin, including its trade names, classification as a vasodilator, and mechanism of action. Perfect for paramedic students or healthcare professionals looking to refresh their knowledge on this important medication.