ACP Nitroglycerin Spray

  1. Nitroglycerin Spray
    Trade names:
    Nitrostat, Nitro-Bid, Tridil
  2. Nitroglycerin Spray
    • nitrate
    • anti-anginal
    • vasodilator
  3. Nitroglycerin Spray
    • Antianginal:
    • - relaxes vascular smooth muscle of both venous and arterial beds, resulting in a net decrease in the myocardial oxygen consumption. It also dilates coronary vessels, leading to redistribution of blood flow to ischemic tissue and improves collateral circulation
    • Vasodilating:
    • - dilates peripheral vessels, decreasing venous return to the heart (preload) useful in treating pulmonary edema and heart failure. Arterial vasodilation decreases afterload, thereby decreasing left ventricular work and aiding the failing heart
  4. Nitroglycerin Spray
    • Acute coronary syndromes (pain & ischemia with Acute Myocardiac Infarction without hypotension),
    • Suspected ischemic cardiac pain
  5. Nitroglycerin Spray
    • Hypersensitivity to nitrates
    • Unable to initiate IV
    • Increased intracranial pressure
    • Hypotension (Systolic pressure under 100mmHg)
    • Uncorrected hypovolemia
    • Suspected cardiac tamponade or pericarditis
    • Sildenafil (Viagra) or similar generic drug use within 24 hours
    • Avoid use in extreme bradycardia (<50 bpm) or severe tachycardia (> 180 bpm)
    • Important! Right ventricular infarction: use with Extreme Caution- if at all!
  6. Nitroglycerin Spray
    Adverse effects:
    • Hypotension
    • Palpitations
    • Tachycardia
    • Syncope
    • Dry mouth
    • N/V
    • Headache
    • Dizziness
    • Skin rash
  7. Nitroglycerin Spray
    1-3 minutes
  8. Nitroglycerin Spray
    may last 30-60 minutes
  9. Nitroglycerin Spray
    Adult Dosage:
    • SL 0.3 mg tab
    • SL 0.4 mg spray q 5 minute intervals (prn) as long as BP remains > 100 mmHg
  10. Nitroglycerin Spray
    sublingual spray or tablet
  11. Nitroglycerin Spray
    • Do not shake canister if administered as a spray as it will altered the metered dose in a single spray
    • Do not have patient inhale drug on administration as it will alter absorption rate
    • Establish IV prior to or immediately following administration to combat hypotension if necessary
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ACP Nitroglycerin Spray
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