Nitroglycerin: Difference between revisions
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==General== | ==General== | ||
*Type: stimulates cGMP production causing vascular smooth muscle relaxation | *Type: vasodilator; stimulates cGMP production causing vascular smooth muscle relaxation | ||
*Dosage Forms: SL, IV | *Dosage Forms: SL, IV | ||
*Common Trade Names: Nitrolingual, NitroMist, Nitrostat | *Common Trade Names: Nitrolingual, NitroMist, Nitrostat | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Angina, acute=== | |||
* | *0.3 - 0.6mg SL q5min, max: 3 doses within 15 min | ||
*IV form: 5 mcg/min IV, increase 5-20 mcg/min q3-5min. | |||
===[[Hypertension]]=== | |||
*5-200 mcg/min IV, start 5 mcg/min IV and increase 5 mcg/min q3-5min | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===[[Hypertension]]/[[CHF]]=== | |||
*1-5 mcg/kg/min IV, start 0.25-0.5 mcg/kg/min, max: 20 mcg/kg/min | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: safety unknown | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: no adjustment | ||
**Pediatric | **Pediatric: no adjustment | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: not defined | ||
**Pediatric | **Pediatric: not defined | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Pericardial tamponade | |||
*Severe anemia | |||
*[[Sildenafil]] use within the past 24 hours or tadalafil within the past 48 hours<ref>Kloner RA, Hutter AM, Emmick JT, Mitchell MI, Denne J, Jackson G. Time course of the interaction between tadalafil and nitrates. J Am Coll Cardiol. 2003 Nov 19;42(10):1855-60.</ref><ref>Cheitlin MD, Hutter AM Jr, Brindis RG, et al. ACC/AHA/[https://nizagara-online.net Nizagara-online.net] expert consensus document: use of sildenafil (Viagra) in patients with cardiovascular disease: American College of Cardiology/American Heart Association. J Am Coll Cardiol 1999;33:273-82.</ref> | |||
*[[Methemoglobinemia]] | |||
*Caution in hypotension | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*hypotension | |||
*bradycardia | |||
*methemoglobinemia | |||
===Common=== | ===Common=== | ||
*headache | |||
*dizziness | |||
*flushing | |||
*hypotension | |||
*reflex tachycardia | |||
*edema | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 1-3 min | ||
*Metabolism: | *Metabolism: liver, erythrocytes, vascular walls | ||
*Excretion: | *Excretion: urine | ||
*Mechanism of Action: | *Mechanism of Action: stimulates cGMP production resulting in vascular smooth muscle relaxation | ||
==See Also== | ==See Also== | ||
== | ==External Links== | ||
*[https://emcrit.org/emcrit/scape/ EMCrit: Sympathetic Crashing Acute Pulmonary Edema (SCAPE)] | |||
==References== | |||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:Cardiology]] | |||
Latest revision as of 17:30, 25 February 2024
General
- Type: vasodilator; stimulates cGMP production causing vascular smooth muscle relaxation
- Dosage Forms: SL, IV
- Common Trade Names: Nitrolingual, NitroMist, Nitrostat
Adult Dosing
Angina, acute
- 0.3 - 0.6mg SL q5min, max: 3 doses within 15 min
- IV form: 5 mcg/min IV, increase 5-20 mcg/min q3-5min.
Hypertension
- 5-200 mcg/min IV, start 5 mcg/min IV and increase 5 mcg/min q3-5min
Pediatric Dosing
Hypertension/CHF
- 1-5 mcg/kg/min IV, start 0.25-0.5 mcg/kg/min, max: 20 mcg/kg/min
Special Populations
- Pregnancy Rating: C
- Lactation: safety unknown
- Renal Dosing
- Adult: no adjustment
- Pediatric: no adjustment
- Hepatic Dosing
- Adult: not defined
- Pediatric: not defined
Contraindications
- Allergy to class/drug
- Pericardial tamponade
- Severe anemia
- Sildenafil use within the past 24 hours or tadalafil within the past 48 hours[1][2]
- Methemoglobinemia
- Caution in hypotension
Adverse Reactions
Serious
- hypotension
- bradycardia
- methemoglobinemia
Common
- headache
- dizziness
- flushing
- hypotension
- reflex tachycardia
- edema
Pharmacology
- Half-life: 1-3 min
- Metabolism: liver, erythrocytes, vascular walls
- Excretion: urine
- Mechanism of Action: stimulates cGMP production resulting in vascular smooth muscle relaxation
See Also
External Links
References
- ↑ Kloner RA, Hutter AM, Emmick JT, Mitchell MI, Denne J, Jackson G. Time course of the interaction between tadalafil and nitrates. J Am Coll Cardiol. 2003 Nov 19;42(10):1855-60.
- ↑ Cheitlin MD, Hutter AM Jr, Brindis RG, et al. ACC/AHA/Nizagara-online.net expert consensus document: use of sildenafil (Viagra) in patients with cardiovascular disease: American College of Cardiology/American Heart Association. J Am Coll Cardiol 1999;33:273-82.