Nitroglycerin (Nitrostat,Tridil,and others)

  1. Class
  2. 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 and, thereby, myocardial oxygen demand.
  3. Indications
    Acute angina pectoris, ischemic chest pain, hypertension, CHF, pulmonary edema.
  4. Contraindications
    Hypotension, hypovolemia; intracranial bleeding or head injury; previous administration of Viagra, Revatio, Levitra, Cialis, or similar agents within past 24 hours.
  5. Adverse reactions
    Headache, hypotension, syncope, reflex tachycardia, flushing, nausea, vomiting, diaphoresis, muscle twitching.
  6. Drug Interactions
    Additive effects with other vasodilators; incompatible with other drugs IV.
  7. 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).
    • NTG spray: 0.4 mg-0.8 mg under the tongue.
    • NTG IV (Tridil).
  8. Dosage and Administration
    • Adult: Tablets; 0.3-0.4 mg SL; may repeat in 3-5 minutes to maximum of 3 doses.
    • NTG spray : 0.4 mg under the tongue; 1-2 sprays.
    • NTG IV infusion: begin at 10 to 20 mcg/min; increase by 5-10 mcg/min every 5 minutes
    • until desired effect.
    • Pediatric: Not recommended.
  9. 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.
  10. Special Considerations
    Pregnancy safety: Category C. Hypotension more common in geriatric poulation. NTG decomposes if exposed to light or heat. Must be kept in airtight containers. Active ingredient may have a stinging effect when administered.
  11. Trade Names
    Nitrostat, Tridil
Card Set
Nitroglycerin (Nitrostat,Tridil,and others)
Paramedic Pharmacology