Nitroglycerin drug card PDF

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Summary

drug card for nitroglycerin nursing notes...

Description

ACTIVE LEARNING TEMPLATE:

Medication

STUDENT NAME: _Catheryn Kelley______________________________________________

PURPOSE OF MEDICATION

MEDICATION GENERIC:__Nitroglycerin___________________TRADE:__Nitro________________________________ PHARMACOLOGIC CLASS: _Nitrates________________________________________________________

MECHANISM OF ACTION: Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Produces vasodilation (venous greater than arterial). Decreases left ventricular enddiastolic pressure and left ventricular end-diastolic volume (preload). Reduces myocardial oxygen consumption

THERAPEUTIC CLASS & USE:

Relief or prevention of anginal attacks. Increased cardiac output. Reduction of BP.

ROUTE & DOSAGE:

CONTRAINDICATIONS & PRECAUTIONS:

-SL (Adults): 0.3– 0.6 mg; may repeat q 5 min for 2 additional doses for acute attack. -Translingual Spray (Adults): 1– 2 sprays; may be repeated q 5 min for 2 additional doses for acute attack. Both may also be used prophylactically 5– 10 min before activities that may precipitate an acute attack. -PO (Adults): 2.5– 9 mg q 8– 12 hr. -IV (Adults): 5 mcg/min; increase by 5 mcg/min q 3– 5 min to 20 mcg/min; if no response, increase by 10– 20 mcg/min q 3– 5 min (dosing determined by hemodynamic parameters; max: 200 mcg/min). -Transdermal (Adults): Ointment—1– 2 in. q 6– 8 hr. -Transdermal patch—0.2– 0.4 mg/hr initially; may titrate up to 0.4– 0.8 mg/hr. Patch should be worn 12– 14 hr/day and then taken off for 10– 12 hr/day

Contraindicated in: Hypersensitivity; Severe anemia; Pericardial tamponade; Constrictive pericarditis; Alcohol intolerance (large IV doses only); Concurrent use of PDE-5 inhibitor (sildenafil, tadalafil, vardenafil). Use Cautiously in: Head trauma or cerebral hemorrhage; Glaucoma; Hypertrophic cardiomyopathy; Severe liver impairment; Malabsorption or hypermotility (PO); Hypovolemia (IV); Normal or lower pulmonary capillary wedge pressure (IV); Cardioversion (remove transdermal patch before procedure);OB: May compromise maternal/fetal circulation.

ADVERSE EFFECTS: CNS: dizziness, headache, apprehension, restlessness, weakness. EENT: blurred vision. CV: hypotension, tachycardia, syncope. GI: abdominal pain, nausea, vomiting. Derm: contact dermatitis (transdermal). Misc: alcohol intoxication (large IV doses only), cross-tolerance, flushing, tolerance.

INTERACTIONS:

ONSET/PEAK/DURATION:

Drug-Drug: Concurrent use of nitrates in any form with sildenafil, tadalafil, and vardenafil increase risk of serious and potentially fatal hypotension; concurrent use is contraindicated. Additive hypotension with antihypertensives, acute ingestion of alcohol, beta blockers, calcium channel blockers, haloperidol, or phenothiazines. Agents having anticholinergic properties (tricyclic antidepressants, antihistamines,  Assess location, duration, intensity, and precipitating factors of patient’s phenothiazines) may decrease absorption of translingual or sublingual anginal pain. nitroglycerin.  Monitor BP and pulse before and after administration. Patients receiving IV nitroglycerin require continuous ECG and BP monitoring. Additional hemodynamic parameters may be monitored.

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NURSING ASSESSMENT:

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(SI/Translingual) onset: 1-3 min/duration 30-60 min (PO-ER) onset: 40-60 min / duration 8-12 hr (oint) onset: 20-60 min / duration: 4-8 hr (patch) onset: 40-60 min / duration: 8-24 hour

PATIENT EDUCATION: Instruct patient to take medication as directed, even if...