CARDIOVASCULAR DRUGS: PHARMACOLOGY

ANTIARRHYTHMIC DRUGS –
NITRATES (NITROGLYCERIN)
November 02, 2020
Transcribers: Celada, Kyrriel J.
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PHARMACOTHERAPEUTICS IMPLEMENTATION

⎯ Relieve ⎯ Tablets may be given on an empty

⎯ Prevent angina stomach, either 30 minutes before or 1 to
2 hours after meals. Tell the patient to
swallow tablets whole, not chew them.
PHARMACOKINETICS ⎯ Have the patient sit or lie down when
receiving the first nitrate dose. Take his
⎯ Sublingually (under the tongue) pulse and blood pressure before giving the
⎯ Buccally (in the pocket of the cheek) dose and when the drug action starts.
⎯ As chewable tablets ⎯ Don’t give a beta-adrenergic blocker or
⎯ As lingual aerosols (sprayed onto or calcium channel blocker to relieve acute
under the tongue) angina.
⎯ Via inhalation (amyl nitrite) ⎯ Withhold the dose and notify the
prescriber if the patient’s heart rate is less
than 60 beats/minute or his systolic blood
PHARMACODYNAMICS pressure drops below 90 mm Hg, or follow
the prescriber’s ordered parameters for
⎯ Nitrates cause the smooth muscle of the withholding the medication.
veins and, to a lesser extent, the arteries ⎯ Dilute IV nitroglycerin with D5W or normal
to relax and dilate. saline solution for injection, using a glass
⎯ By reducing preload, nitrates reduce bottle.
ventricular size and ventricular wall ⎯ Administer sublingual nitroglycerin
tension. tablets at the first sign of an attack,
⎯ This, in turn, reduces the oxygen placing the medication under the tongue
requirements of the heart. until it’s completely absorbed. The dose
can be repeated every 5 minutes up to
three doses.
DRUG INTERACTIONS ⎯ Place topical ointments on paper as
prescribed; then place the paper on a non-
⎯ Alcohol hairy area and cover it with plastic.
⎯ Anticholinergic drug Remember to rotate application sites and
⎯ Calcium channel blockers make sure you don’t get any ointment on
your fingers.
⎯ Remove a transdermal patch before
ADVERSE REACTIONS defibrillation. Aluminum backing on the
patch may explode with electric current.
⎯ Headache
⎯ Be aware that the drug may initially cause
⎯ Hypotension
headache until tolerance develops or the
⎯ Dizziness
dosage is minimized.
⎯ Increased heart rate

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