GTN

MOA

vasodilator lowers preload

Indications

myocardial ischaemia, cardiogenic pulmonary oedema, control of hypertension for autonomic dysreflexia, STEMI

Contraindications

Known severe allergy, Systolic BP less than 110mmHg, HR less than 40bpm or greater than 150bpm, VT

Cautions

STEMI (can cause fall in CO), frail patient, signs of shock, dysrhthmias, taken phosphodiesterase inhibitor in last 24 hrs, known aortic or mitral stenosis (ask about rheumatic fever or strep) CO may be low cause of narrowed valve GTN can worsen

Dosage

MI=0.4mg SL every 5min 10min if caution. STEMI=0.4mg with caution withhold if signs of poor perfusiion. Cardiogenic pulmonary oedema=0.8mg every 5 minutes. Consider increase to 10 min if caution is present. increase dose and frequency if patient is not improving

Onset

1-2min

Duration

15-30min