Cardiovascular Medicine Book

Congestive Heart Failure

Coronary Artery Disease

Electrocardiogram

Examination

Hyperlipidemia

Hypertension

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Pericardial Disorders

Obstetrics Chapter related topics

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Nitroglycerin DripAka: Intravenous Nitroglycerin, Nitroglycerin Infusion

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  1. Indications
    1. Acute Myocardial Ischemia (Angina Pectoris)
    2. Acute Myocardial Infarction
      1. Limits infarct expansion
      2. Reduces infarct size
        1. Inferior wall Myocardial Infarction
        2. Congestive Heart Failure associated with infarction
      3. Decreases vasospasm at site of Plaque rupture
    3. Congestive Heart Failure
  2. Preparation
    1. Mix 50 mg Nitroglycerin in 250 ml D5W
  3. Dosing
    1. Bolus: 12.5 to 25 ug Nitroglycerin IV
    2. Maintenance
      1. Start: 10-20 ug/min (3-6 ml/hour)
      2. Titrate: Increase 5 to 10 ug/min every 5-10 minutes
      3. Usual dosage: 50 to 200 ug/min (maximum 500 ug/min)
      4. Endpoints
        1. Blood Pressure drop over 10%
        2. Adequate decrease in systemic vascular resistance
        3. Adequate fall in left ventricular filling pressure
        4. Relief of Chest Pain

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