Nitroglycerin sublingual tablets are used to treat episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). It is also used just before activities that may cause episodes of angina in order to prevent the angina from occurring.
Why nitroglycerin is not given IV?
Intravenous nitroglycerin is contraindicated in patients with constrictive pericarditis, restrictive cardiomyopathy, or cardiac tamponade because the drug reduces venous return, decreases preload, and decreases cardiac output, which can be worsened in patients with these conditions.
Why is nitroglycerin given sublingually instead of orally?
Glyceryl trinitrate (or nitroglycerin) undergoes extensive hepatic presystemic metabolism when given orally. Therefore, it is usually given by the sublingual route, by which it is well absorbed and rapidly taken up into the circulation.
What are the different routes of administration for nitroglycerin?
The forms of nitroglycerin typically administered by EMS providers of different levels include sublingual tablets or sprays; transdermal paste; and, for some advanced providers, IV nitroglycerin solutions.
What happens if you chew nitroglycerin?
Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth. Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving.
Why are drugs given sublingually?
Sublingual administration of drug refers to the placement of drug under the tongue (Rehfeld et al., 2017). The sublingual route bypasses the first-pass metabolism and hence facilitates rapid absorption of the drug into the systemic circulation. Drug directly reaches the systemic circulation using blood vessels.
What is nitroglycerin IV?
Descriptions. Nitroglycerin injection is used to treat hypertension (high blood pressure) during surgery or to control congestive heart failure in patients who have had a heart attack. It may also be used to produce hypotension (low blood pressure) during surgery.
How is nitroglycerin administered?
Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving. Nitroglycerin sublingual tablets usually give relief in 1 to 5 minutes.
What happens if you swallow sublingual nitroglycerin?
Place the under-the-tongue (sublingual) tablet under your tongue. Leave it there until it dissolves. If you accidentally swallow the tablet, take another. The medicine won’t work if it is swallowed.
Why is nitroglycerin in a glass bottle?
Abstract. Nitroglycerin is a volatile substance which evaporates from tablets if strict precautions are not taken. The tablets kept in small, amber, tightly capped glass bottles in a refrigerator maintain their potency for three to five months if bottles are opened once a week.
What type of explosive is nitroglycerin?
In its undiluted form, nitroglycerin is a contact explosive, with physical shock causing it to explode. If it has not been adequately purified during manufacture it can degrade over time to even more unstable forms. This makes nitroglycerin highly dangerous to transport or use.
How is nitroglycerin administered in the hospital?
There are intravenous (IV) routes of administration for nitroglycerin used most commonly in emergency rooms and intensive care units (ICU). It is administered as a 5% dextrose in drip and is indicated when sublingual nitroglycerin has failed to provide symptomatic relief or if rapid and continued relief of symptoms is necessary.
How is the effectiveness of nitroglycerin measured?
When administered sublingually, nitroglycerin’s effectiveness is typically measured via the resolution of symptoms; angina, hypertension, and congestive heart failure. In the event of overdose, monitoring vital signs may be necessary to monitor the hemodynamic effects of nitroglycerin.
What is an example of a sublingual strip of medication?
Nitroglycerine tablets are an example, the anti-emetic ondansetron is another. Sublingual strips—similar to tablets in that they easily melt in the mouth and dissolve rapidly. Suboxone is an example of medication that comes in a sublingual strip.
What are the contraindications to nitroglycerin therapy?
Known history of increased intracranial pressure, severe anemia, right-sided myocardial infarction, or hypersensitivity to nitroglycerin are all contraindications to nitroglycerin therapy. Concurrent use of nitroglycerin with PDE-5 inhibitors (e.g., sildenafil citrate, vardenafil hydroxide, tadalafil) is absolutely contraindicated.
