Nitroglycerin

1. Therapeutic Effects
   1. Antianginal
   2. Vasodilator
   3. Smooth muscle relaxant
   4. Vasodilation (coronary and systemic arteries and venous system)

2. Indications
   1. Angina Pectoris
   2. Chest pain associated with acute coronary syndromes
   3. Hypertensive crisis (ALS)
   4. Acute Pulmonary Edema or CHF (ALS)

3. Contraindications/Precautions
   1. Hypotension (BP <100 systolic)
   2. Pt's under 12 years of age
   3. Contraindicated for EMT-I's when IV access not established
   4. Patients that are prescribed medications to treat erectile dysfunction (ED) will not be given nitroglycerin without on-line medical control orders. Some of these medications for ED are: Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil). Acute hypotension may develop with administration of nitrates concurrently with these medications.
      
4. Side Effects
   1. Headache
   2. Hypotension
   3. Dizziness
   4. Rare: Idiopathic bradycardia/hypotension

5. Administration and Dosage
   1. 0.4 mg SL repeated every 5/minutes or until pain diminished, max 1.2 mg