1. Terry White, RN, EMT-P1 NITROGLYCERIN

2. Terry White, RN, EMT-P2 Nitroglycerin Indications –Ischemic Chest Pain

3. Terry White, RN, EMT-P3 Nitroglycerin Contraindications –BP<100mm Hg –Pt. Has already taken maximum dose of three doses (1.2mg)

4. Terry White, RN, EMT-P4 Nitroglycerin Dose –.4mg sublingual Tablet or Metered-dose Spray –.4mg Trans-dermal patch –May repeat at 5 minute intervals up to 3 doses (1.2mg)

5. Terry White, RN, EMT-P5 Nitroglycerin Mechanism of Action –Relaxes vascular smooth muscle

6. Terry White, RN, EMT-P6 Nitroglycerin Effects –Decreased pre-load –Decreased after-load –Increased blood flow to Ischemic Myocardium

7. Terry White, RN, EMT-P7 Nitroglycerin Side Effects –Hypotension –Reflex Tachycardia –Headache

8. Terry White, RN, EMT-P8 Nitroglycerin Comments –Most effective when Pt is sitting –If tablet form - Protect potency Store in original brown bottle Keep tightly sealed Protect from light, air, heat Secure new supply every 4 - 6 months

9. Terry White, RN, EMT-P9 Nitroglycerin Potent Nitroglycerin –Headache –Burning sensation under tongue