IV nitroglycerine alternatives

Background

  • Suggestions for substitution during the IV shortage

Nitroglycerine Bioavailability

  • Oral [1]: <1%
  • Sublingual [1]: 38% (15-40%)
  • Topical [1]: 72%

Half-life[2]: 0.05 h

Suggested Substitutions[3]

  1. Sublingual nitroglycerin, 1-2 tabs or sprays every 5 minutes as needed
    1. Once controlled
      1. Nitropursside OR Isordil PO (nitro paste or longer acting NTG)
    2. If not well controlled
      1. IV enalapril 0.625-1.25mg IV bolus
      2. IV hydralazine 5-10mg IV bolus
      3. IV nitropursside

See Also

References

<references>

  1. ↑ 1.0 1.1 1.2 http://sepia.unil.ch/pharmacology/index.php?id=51
  2. ↑ http://sepia.unil.ch/pharmacology/index.php?id=60
  3. ↑ http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/45056
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