- Class
- Nitrates
- Body system
- Cardiovascular
- Brand names
- Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid
What is Nitroglycerin used for?
- Acute angina (sublingual tablet or spray)
- Angina prevention (patch, ointment)
- Acute coronary syndrome, acute heart failure and hypertension (IV)
How Nitroglycerin works
Releases nitric oxide: dilates veins (less preload) and coronary arteries, lowering the heart's oxygen demand.
Common side effects
- Headache
- Hypotension and dizziness
- Flushing
- Reflex tachycardia
Report right away
- Chest pain that does not improve 5 minutes after the first dose: call 911
- Fainting
Nursing considerations for Nitroglycerin
- Check the blood pressure before and after each dose; have the patient sit or lie down.
- Contraindicated with phosphodiesterase-5 inhibitors (sildenafil, vardenafil within 24 hours; tadalafil within 48 hours): severe hypotension.
- Patches and ointment: remove the old dose, rotate hairless sites, wear gloves, and keep the nitrate-free interval ordered (often 10 to 12 hours, usually overnight) to prevent tolerance.
Patient teaching
- Sublingual: at the first sign of chest pain, stop activity, sit down and place 1 tablet under the tongue. If pain is not better or is worse 5 minutes after the first dose, call 911. Doses can be repeated every 5 minutes, up to 3.
- Keep tablets in their original dark glass container, away from heat and moisture; replace them by the expiration date.
- A headache is common and usually eases with time.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Nitrates practice questions
NCLEX-style questions on the class Nitroglycerin belongs to.
3 questions. Choose an answer to see the rationale.
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A patient using sublingual nitroglycerin still has chest pain 5 minutes after the first tablet. What should the patient do?
Show answer
Answer B: Call 911 Current guidance is to call 911 if chest pain is unimproved or worse 5 minutes after the first dose, then continue as directed by EMS.
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Which drug taken in the past 24 hours is a contraindication to nitroglycerin?
Show answer
Answer C: Sildenafil Phosphodiesterase-5 inhibitors combined with nitrates can cause severe, life-threatening hypotension.
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Why is a nitroglycerin patch removed for 10 to 12 hours each day?
Show answer
Answer C: To prevent nitrate tolerance Continuous nitrate exposure leads to tolerance; a daily nitrate-free interval keeps the drug effective.
Frequently asked questions
What is Nitroglycerin used for?
Acute angina (sublingual tablet or spray); Angina prevention (patch, ointment); Acute coronary syndrome, acute heart failure and hypertension (IV).
What drug class is Nitroglycerin?
Nitroglycerin belongs to the class nitrates. Releases nitric oxide: dilates veins (less preload) and coronary arteries, lowering the heart's oxygen demand.
What are the nursing considerations for Nitroglycerin?
Check the blood pressure before and after each dose; have the patient sit or lie down. Contraindicated with phosphodiesterase-5 inhibitors (sildenafil, vardenafil within 24 hours; tadalafil within 48 hours): severe hypotension.
What should patients report while taking Nitroglycerin?
chest pain that does not improve 5 minutes after the first dose: call 911; fainting.