DRUG

Nitoglycerin
(ISMN)
60 mg /tab
OD

ACTION

A nitrate that
reduces cardiac
oxygen demand by
decreasing left
ventricular enddiastolic pressure
(preload) and, to a
lesser extent,
systemic vascular
resistance
(afterload). Also
increase blood flow
through the
collateral coronary
vessels

INDICATION

CONTRAINDICATION

ADVERSE
REACTION

To prevent chronic
angina attacks

Contraindicated in
patients with early
MP (oral and
sublingual), severe
anemia. Increased
intracranial pressure,
angle-closure
glaucoma, orthostatic
hypotension, allergy
to adhesives
(transdermal). Or
hypersensitivity to
nitrates. I.V.
nitroglycerin is
contraindicated in
patients
hypersensitive to I.V.
form, w/ cardiac
tamponade, restrive
cardiomyopathy or
constrictive
pericarditis

CNS: headache,
dizziness,
weakness

Acute angina pectoris;

to prevent or minimize
angina attacks before
stressful events
Hypertension from
surgery, heart failure
after MI, angina
pectoris in acute
situations. To produce
controlled hypotension
during surgery (by I.V
infusion)

CV: orthostatic
hypotension,
tachycardia,
flushing,
palpitations,
fainting
EENT: S.L.
burning
GI: nausea,
vomiting
SKIN: cutaneous
vasodilation,
contact dermatitis,
rash

NURSING
RESPONSIBILTIES

PATIENT
TEACHING

Closely monitor
vital signs during
infusion, particularly
blood pressure,
especially in a
patient with an MI.
excessive
hypotension may
worsen the MI

Caution patient
to take
nitroglycerin
regularly, as
prescribed, and
to have it
accessible at all
times

To apply ointment,
measure the
prescribed amount
on the application
paper; then place the
paper on any
nonhairy area. Dont
rub in. Cover w/
plastic film to aid
absorption and to
protect clothing.
Remove all excess
ointment from
previous site before
applying next dose

Advise patient
that stopping
drug abruptly
causes spasm of
the coronary
arteries
Teach patient
how to give the
prescribed form
of nitrogly cerin