Nitroglycerin

Vasodilator, nitrate, antianginal

1. Relaxes smooth muscles causing venous dilation
2. Reduces preload and afterload to the heart
3. Dilates the coronary arteries resulting in increased perfusion of the myocardium

1. Chest pain cardiac origin
2. Acute pulmonary Edema

1. Blood pressure less than 90 mmHg systolic
2. Patients who have taken Erectile Dysfunction (PDE5 Inhibitors) medications in the last 24-48 hours
3. Signs and systems of head trauma (increasers intracranial pressure) or cerebral hemorrhage
4. Poor systemic perfusion

CARDIOVASCULAR: Hypotension, bradycardia, rebound hypertension/ tachycardia, palpations
NEUROLOGICAL: headache
OTHER: Flushed skin, sublingual burning

Monitor blood pressure closely for signs of hypotension (Before and after administration)

Use with caution with patients who already use vasodilators, alcohol, calcium channel blockers, beta blockers and phenothiazides

SL, TM (Transmucosal), Transdermal (nitropaste)

Onset in 1-3 minutes and may last 30-60 minutes

ADULT: 0.4 mg as a single spray or single tablet. May repeat every 3-5 minutes Nitropaste in 15 mg per one inch, doses are protocol dependent
PEDIATRIC: Not Recommended

1. Do not shake canister if administered as a spray as it will altered the metered dose in a single spray
2. Do not have patient inhale drug on administration as it will alter absorption rate
3. Establish IV prior to or immediately following administration to combat hypotension if necessary