cardiovscualr medication:Organic Nitrates: nitroglycerin

use of Organic Nitrates: nitroglycerin 

• Angina

• Prophylaxis for chronic stable angina or Prinzmetal’s angina

MOA

Vasodilates coronary arteries and veins increasing coronary blood flow

complications

• Headache:

• Orthostatic hypotension

• Reflex tachycardia

• Tolerance

Contraindications

• Allergy to nitrates

• Use with caution with other HTN medication, hyperthyroidism, kidney or liver dysfunction.

Drug/drug interactions

• Alcohol can cause further hypotension

• Other med for HTN, diuretics, can lead to further hypotension

• Viagra 

Inhibitors of PDES₅  causes FATAL hypotension  

Nursing Education

Sublingual tab 

Use at first indication of CP.  Place 1 tab SL, repeat in 5 mins, repeat again in 5 mins if needed. 

Use prior to activity that is known to cause CP

Place under tongue 

Store in original bottles, light sensitive

Nursing education

Translingual Spray

Spray against oral mucosa

Avoid inhaling

Nursing education

Sustained Released

Long term prophylaxis against angina attack

Take with 8 oz water

Do not crush or chew

Transdermal

Do not cut patch

Place on hairless patch of skin in the am & rotate sites

Remove patch at night to reduce risk of tolerance & to be medication free 10-12 hr/day

Topical

Remove previous dose before applying new dose

Use applicator paper

Do not touch ointment

IV

Use tubing provided by manufacturer & glass bottle

Start at low rate (5 mcg/mn) titrate to therapeutic, 

Continuous ECG monitoring