Nitroglycerin (Nitrostat) Drugs Study

MEDICATION Nitroglycerin (Nitrostat) DRUG CLASSIFICATION Nitrates Drugs INDICATION/ CONTRAINDICATION MECHANISM OF ACTION DOSAGE & ADMINISTRATION ADVERSE REACTION NURSING RESPOSIBILITIES

To prevent chronic anginal attacks Acute angina pectoris; to prevent or minimize anginal attacks before stressful events Hypertension from surgery, heart failure after MI, angina pectoris in acute situations, to produce controlled hypotension during surgery (by I.V. infusion)

A nitrate that reduces cardiac oxygen demand by decreasing left ventricular enddiastolic pressure (preload) and, to a lesser extent, systemic vascular resistance (afterload). Also increases blood flow through the collateral coronary vessels.

Capsules (sustainedrelease): 2.5 mg, 6.5 mg, 9 mg, 13 mg

CNS: headache, dizziness, weakness. CV: orthostatic hypotension, tachycardia, flushing, palpitations, fainting. EENT: S.L. burning. GI: nausea, vomiting. Skin: cutaneous vasodilation, contact dermatitis, rash. Other: hypersensitivity reactions.

Caution patient to take nitroglycerin regularly, as prescribed, and to have it accessible at all times. Alert: Advise patient that stopping drug abruptly causes spasm of the coronary arteries. Teach patient how to give the prescribed form of nitroglycerin. Tell patient to take S.L. tablet at first sign of attack. Patient should wet the tablet with saliva and place under the tongue until absorbed; he should sit down and rest. Dose may be repeated every 5 minutes for a maximum of three

doses. If drug doesn't provide relief, he should obtain medical help promptly. Advise patient who complains of a tingling sensation with S.L. drug to try holding tablet in cheek. Tell patient to take oral tablets on an empty stomach either 30 minutes before or 1 to 2 hours after meals, to swallow oral tablets whole, and not to chew tablets. Remind patient using translingual aerosol form that he shouldn't inhale the spray, but should release it onto or under the tongue. Tell him to wait about 10 seconds or so before swallowing.

Tell patient tplace the buccal tablet between the lip and gum above the incisors or between the cheek and gum. Tablets shouldn't be swallowed or chewed. Tell patient to take an additional dose before anticipated stress or at bedtime if chest pain occurs at night. Urge patient using skin patches to dispose of them carefully because enough medication remains after normal use to be hazardous to children and pets. Advise patient to avoid alcohol. To minimize dizziness when standing up, tell patient to rise slowly. Advise him

to go up and down stairs carefully and to lie down at the first sign of dizziness. Advise patient that use of sildenafil, tadalafil, or vardenafil with any nitrate may cause severe low blood pressure. The patient should talk to his prescriber before considering use of these drugs together. Tell patient to store drug in cool, dark place in a tightly closed container. Tell him to remove cotton from container because it absorbs drug. Tell patient to store S.L. tablets in original container or other container specifically approved for this use and to carry the container

in a jacket pocket or purse, not in a pocket close to the body.