Antianginals

Section 8 - MEDICATION GUIDELINES

8.05 ANTIANGINALS

Nitroglycerin Drip (NITROL, TRIDIL, NITROSTAT) / Antianginal

DESCRIPTION

• Reduces cardiac oxygen demand by decreasing preload and afterload. Also increases blood flow through the collateral coronary vessels.

INDICATIONS

• Chest pain associated with Angina Pectoris and Myocardial Infarction, CHF, HTN,

CONTRAINDICATIONS

• Increased intracranial hemorrhage. Hypersensitivity to the medication. Systolic BP < 90 mm Hg.
  • Administer with caution and only use a nitro drip in patients who present with potential Right Ventricular Infarction as identified by a 12 Lead EKG.

PRECAUTIONS

• It may induce headache that is sometimes severe. Patients may develop tolerance. Watch for hypotension. MUST BE ON AN INFUSION REGULATOR.

DOSAGE

• Initial infusion rate is 5-15 mcg / minute. Titrate to effect.
• See appendices for infusion rate chart.

Nitroglycerin Spray (NITROLINGUAL SPRAY) / Antianginal

DESCRIPTION

• It is an aerosol preparation that delivers exactly 0.4 mg with each spray. Peak effect in 4 minutes.

INDICATIONS

• Chest pain associated with Angina Pectoris and Myocardial Infarction, Acute Pulmonary Edema.

CONTRAINDICATIONS

• Increased intracranial pressure. Hypersensitivity to the medication. Systolic BP < 90 mm Hg.
• Do not administer in patients who present with potential Right Ventricular Infarction as identified by a 12 Lead EKG.

PRECAUTIONS

• It may induce headache that is sometimes severe. Patients may develop tolerance. The spray should not be inhaled. Watch for hypotension.

DOSAGE

• 0.4 mg sublingually AND refer to appropriate PRACTICE PARAMETER for specific dosages.

Nitroglycerin Tablets (NITROLINGUAL TABLETS) / Antianginal

DESCRIPTION

• It is a tablet containing 0.4mg of Nitroglycerin.

INDICATIONS

• Chest pain associated with Angina Pectoris and Myocardial Infarction, Acute Pulmonary Edema.

CONTRAINDICATIONS

• Increased intracranial pressure. Hypersensitivity to the medication. Systolic BP < 90 mm Hg.

PRECAUTIONS

• It may induce headache that is sometimes severe. Patients may develop tolerance. The tablet should not be swallowed. Watch for hypotension.

DOSAGE

• 0.4 mg sublingually AND refer to appropriate PRACTICE PARAMETER for specific dosages.