To view or add a comment, sign in Nitroglycerin (NTG) Class: Organic nitrate Vasodilator Mechanism of Action Converted to nitric oxide (NO) in vascular smooth muscle Activates guanylate cyclase cGMP smooth muscle relaxation Effects: Venodilation preload (reduces myocardial oxygen demand) Coronary artery dilation oxygen supply to ischemic myocardium Arterial dilation at higher doses afterload Indications Acute angina pectoris (chest pain) Chronic stable angina (prophylaxis) Acute coronary syndromes (adjunct therapy) Heart failure with acute pulmonary edema Routes of Administration Sublingual tablets / spray: Rapid relief of acute angina Oral / extended-release tablets: Long-term prophylaxis Transdermal patch / ointment: Continuous delivery for chronic angina IV infusion: Severe heart failure, acute MI, hypertensive emergencies Dosage (Typical) Sublingual: 0.30.6 mg every 5 minutes as needed, max 3 doses in 15 min Transdermal patch: 0.10.8 mg/hr (patch-free interval recommended to prevent tolerance) IV infusion: Start 5 mcg/min, titrate to effect Adverse Effects Headache (most common) Hypotension dizziness, syncope Flushing, tachycardia (reflex) Nausea Methemoglobinemia (rare, high doses or IV) Precautions / Contraindications Avoid with PDE-5 inhibitors (sildenafil, tadalafil) severe hypotension Use cautiously in hypotension, severe anemia, increased intracranial pressure Tolerance develops with continuous exposure use intermittent dosing or nitrate-free interval Rapid-acting vasodilator for acute angina sublingual route preferred Main side effect: headache, hypotension Avoid nitrates with sildenafil life-threatening hypotension Reduces preload (primary) and afterload (secondary) To view or add a comment, sign in Potassium in DKA: Treat It Right or Risk the Heart In Diabetic Ketoacidosis (DKA), potassium management is just as critical as insulin therapy
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