Nitroglycerin



Nitroglycerin





(nye troe gli’ ser in)

Intravenous: generic

Ointment: Rectiv

Spray: Nitrolingual Pumpspray

Sublingual: Gen-Nitroglycerin (CAN), Nitrostat

Sustained-release: Nitro-TimeDNC

Topical: Nitro-Bid

Transdermal: Minitran, Nitrek, Nitro-Dur

Translingual: Nitrolingual

PREGNANCY CATEGORY C


Drug Classes

Antianginal

Nitrate


Therapeutic Actions

Relaxes vascular smooth muscle with a resultant decrease in venous return and decrease in arterial BP, which reduces left ventricular workload and decreases myocardial oxygen consumption.


Indications



  • Sublingual, translingual preparations: Acute angina


  • Oral SR, sublingual, topical, transdermal, translingual preparations: Prophylaxis of angina


  • IV: Angina unresponsive to recommended doses of organic nitrates or beta blockers


  • IV: Perioperative hypertension


  • IV: HF associated with acute MI


  • IV: To produce controlled hypotension during surgery


  • Topical ointment: Treatment of moderate to severe pain associated with anal fissure (Rectiv)


  • Unlabeled uses: Reduction of cardiac workload in acute MI and in HF (sublingual, topical) adjunctive treatment of Raynaud disease (topical)



Available Forms

Injection for solution (requires dilution)—5 mg/mL; injection (premixed)—100, 200, 400 mcg/mL; sublingual tablets—0.3, 0.4, 0.6 mg; ER buccal tablets—2.3 mg; translingual spray—0.4 mg/spray; oral SR capsules—2.5, 6.5, 9 mg; transdermal—0.1, 0.2, 0.3, 0.4, 0.6, 0.8 mg/hr; topical ointment—0.4%, 2%


Dosages

Adults

IV

Initial dose, 5 mcg/min IV delivered through an infusion pump. Increase by 5-mcg/min increments every 3–5 min as needed. If no response at 20 mcg/min, increase increments to 10–20 mcg/min. Once a partial BP response is obtained, reduce dose and lengthen dosage intervals; continually monitor response and titrate carefully.

Sublingual



  • Acute attack: Dissolve one tablet under tongue or in buccal pouch at first sign of anginal attack; repeat every 5 min until relief is obtained. Do not take more than three tablets/15 min. If pain continues or increases, patient should call physician or go to hospital.


  • Prophylaxis: Use 5–10 min before activities that might precipitate an attack.

Buccal

Place tablet between the lip and gum and allow it to dissolve over 3–5 min. Do not chew or swallow the tablet. Initial dose is 1 mg every 5 hr while awake. Maintenance dose is 2 mg tid.

SR (oral)DNC

Initial dose, 2.5–9 mg every 12 hr. Increase to every 8 hr as needed and tolerated. Doses as high as 26 mg given qid have been used.

Topical

Initial dose, one-half inch every 8 hr. Increase by one-half inch to achieve desired results. Usual dose is 1–2 inches every 8 hr; up to 4–5 inches every 4 hr have been used. 1 inch = 15 mg nitroglycerin.

Transdermal

Apply one patch each day. Adjust to higher doses by using patches that deliver more drug
or by applying more than one patch. Apply patch to arm; remove at bedtime.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jul 21, 2016 | Posted by in NURSING | Comments Off on Nitroglycerin

Full access? Get Clinical Tree

Get Clinical Tree app for offline access