Page 46 - RxExam's Naplex Theory Review Part-1

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Dose Special Notes

Nitroglycerine One tablet should be 1). Venous vasodilation produced by nitrates is mainly
1. Sublingual dissolved under the tongue or responsible for their antianginal actions. The dilation of
tablet in the buccal pouch at the coronary blood vessels reduces the preload of the heart
2. Transdermal first sign of an acute anginal (by reducing left ventricular volume) and reduces its
system attack. oxygen requirements.
3. Buccal tablet The dose may be
4. I.V. infusion repeated approximately 2). It is indicated for relief of an acute angina attack or
5. Ointment
every 5 minutes until relief is prophylaxis of angina pectoris due to coronary artery
obtained. If the pain persists disease.
after a total of 3 tablets in a
15-minute period, or if the 3). Deponit, Transdermal-Nitro, and Nitro-Dur are
pain is different than is transdermal systems of Nitroglycerine that deliver 0.1 mg,
typically experienced, 0.2 mg, 0.3 mg, 0.4 mg, 0.6 mg or 0.8 mg of Nitroglycerine
prompt medical attention is per hour. Transdermal systems should be worn for 12
recommended. hours daily.

4). Nitrolingual spray is a meter dose spray aerosol
containing 200 doses of Nitroglycerine. Each meter dose
delivers 0.4 mg of Nitroglycerine. At the onset of an attack,
one or two metered doses should be sprayed under the
tongue. Not more than 3 meter doses are recommended
within a 15 minute period.

5). Nitrostat is a sublingual tablet of Nitroglycerine
available in 0.3 mg, 0.4 mg and 0.6 mg strengths. One
tablet should be dissolved under the tongue at the first
sign of an acute anginal attack. The dose may be repeated
every 5 minutes up to total of 3 tablets within 15 minutes.

6). Administration of nitroglycerin is contraindicated in
patients who are using PDE-5 inhibitors (e.g., sildenafil,
tadalafil or vardenafil).

7). Lightheadedness, headaches, hypotension, blurred
vision and dryness of mouth are reported side effects of
Nitroglycerine.

Dosage forms of Onset of actions
Nitroglycerine

I.V. infusion Immediately
Sublingual tablet 1-to-3 minutes
Buccal tablet 3 minutes
Lingual aerosol 2-to-4 minutes
Ointment 30 minutes

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