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== | ||
| Line 24: | Line 29: | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Pericardial tamponade | *Pericardial tamponade | ||
* | *Severe anemia | ||
*sildenafil | *[[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== | ||
| Line 44: | Line 49: | ||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: 1-3 min | *Half-life: 1-3 min | ||
*Metabolism: liver, | *Metabolism: liver, erythrocytes, vascular walls | ||
*Excretion: urine | *Excretion: urine | ||
*Mechanism of Action: stimulates cGMP production resulting in vascular smooth muscle relaxation | *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== | ==References== | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Cardiology]] | |||
Revision as of 15:19, 13 January 2023
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.