Nitroglycerin (IV Infusion)
Generic Details
Generic Name
Nitroglycerin IV Infusion
Other Names
- Nitroglycerin Intravenous
- Nitro IV
Drug Class
- Vasodilator
Chemical Formula
C3H5N3O9
Molecular Weight
227.087 g/mol
Mechanism of Action
- Nitroglycerin is converted to nitric oxide (NO) in smooth muscle cells, leading to vasodilation.
Indications
- Angina pectoris
- Acute coronary syndrome
- Myocardial infarction
- Heart failure with acute pulmonary edema
Common Dosage Forms
- IV Infusion
Typical Dosage
- 5-100 mcg/min continuous IV infusion
Pediatric Dosage
- Not established
Geriatric Dosage
- Lower starting doses may be required due to age-related changes
Side Effects
- Headache
- Hypotension
- Flushing
- Dizziness
- Tachycardia
- Nausea
- Vomiting
Contraindications
- Hypersensitivity to nitroglycerin
- Severe anemia
- Increased intracranial pressure
- Use of phosphodiesterase inhibitors
Pregnancy Category
- C - Risk cannot be ruled out
Lactation Safety
- Compatible
Drug Interactions
- Hypotensive effects potentiated by alcohol, beta-blockers, calcium channel blockers, and phosphodiesterase inhibitors
Overdose Symptoms
- Severe hypotension
- Headache
- Cyanosis
- Weakness
- Syncope
Antidote for Overdose
- Methylene blue
- Vasopressors
Storage Conditions
- Protect from light
- Store at room temperature (20-25°C)
Pharmacokinetics
- Absorption: Rapidly absorbed through mucous membranes in the oral form
- Distribution: Widely distributed, crosses the placenta and enters breast milk
- Metabolism: Metabolized in the liver to inactive metabolites
- Excretion: Primarily excreted renally
Precautions
- Monitor blood pressure closely during administration
- Avoid abrupt withdrawal to prevent rebound hypertension
- Caution in patients with hypovolemia or severe renal or hepatic impairment
Warnings
- May cause severe hypotension, especially in patients with volume depletion or receiving other vasodilators
- Tolerance may develop with prolonged use