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Nitroglycerin
Trade Name
- Nitrostat®
- Nitro-Bid®
- Tridil®
- Nitrolingual®
-
Nitroglycerin
Class
Vasodilators
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Nitroglycerin
Mechanism of Action
- Smooth muscle relaxant acting on vascular, bronchial, uterine and intestinal smooth muscle.
- Dilation of arterioles and veins in the periphery
- Reduces preload and afterload
- Decreases the work load of the heart
- Decreases myocardial oxygen demand
-
Nitroglycerin
Indications
- Acute angina pectoris
- Ischemic chest pain
- Hypertension
- Congestive Heart Failure (CHF)
- Pulmonary edema
-
Nitroglycerin
Contraindications
- Hypotension
- Hypovolemia
- Intracranial bleeding or head injury
- Patients who have taken any of the following phosphodiesterase inhibitor medications within the last 48 hours should not receive NTG:
- Sildenafil (Viagra®)
- Vardenafil (Levitra®)
- Tadalafil (Cialis®)
-
Nitroglycerin
Adverse Reactions
- Headache
- Hypotension
- Syncope
- Reflex tachycardia
- Flushing
- Nausea
- Vomiting
- Diaphoresis
- Muscle twitching
-
Nitroglycerin
Drug Interactions
- Additive effects with other vasodilators
- Incompatible with other drugs IV
- Patients who have taken any of the following phosphodiesterase inhibitor medications within the last 48 hours should not receive NTG:
- Sildenafil (Viagra®)
- Vardenafil (Levitra®)
- Tadalafil (Cialis®)
-
Nitroglycerin
How Supplied
- Tablets: 0.15 mg (1/400 grain); 0.3 mg (1/200 grain);
- 0.4 mg (1/150 grain); 0.6 mg (1/100 grain)
- Spray: 0.4 mg -0.8 mg under the tongue
- Paste: 1 g packets or 30, 60 g tubes
- IV: 25 mg in 250 NS yield 100mcg/ml
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Nitroglycerin
Dosage and Administration
Adult
- Tablets: 0.3 -0.4 mg SL
- Spray: 0.4 mg /1 spray SL may repeat in 3-5 minutes to maximum of 3 doses.
- NTG Paste: 1 inch (1 5 mg) placed on anterior chest
- NTG IV infusion: 25 mg in 250 NS yield 100mcg/ml Run @ 10mcg / min.; increase by 10 mcg / min. every 5 minutes until desired effect or max 300 mcg/min.
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Nitroglycerin
Dosage and Administration
Pediatric
Not recommended
-
Nitroglycerin
Duration of Action
- Onset: 1-3 minutes
- Peak effect: 5-10 minutes
- Duration: 20-30 minutes or. if IV, 1-10 minutes after discontinuation of infusion
-
Nitroglycerin
Special Considerations
- Pregnancy Safety: Category C
- Use with caution if inferior, posterior, right sided STEMI is suspected
- Hypotension more common in geriatric population
- NTG decomposes if exposed to light or heat
- Must be kept in airtight containers
- Active ingredient may have a stinging effect when administered SL
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