#建議持續輸注 (IV pump) 之高警訊藥品

心衰竭、心絞痛、高血壓 (其他) Angina pectoris, acute decompensated heart failure, perioperative hypertension

Antianginal Agent; Vasodilator
Nitroglycerin, an organic nitrate, is a vasodilating agent that relieves tension on vascular smooth muscle and dilates peripheral veins and arteries.

Distribution:
1. Vd: 3 to 3.3 L/kg
2. Protein binding: Approximately 60%
Metabolism:
1. Hepatic: reductase, reduction, hydrolysis
2. Extrahepatic: RBCs and vascular walls.
Excretion:
1. Total body clearance: 13.6 L/min
2. Elimination Half Life: about 3 mins

1. Acute circulatory failure or shock
2. Concomitant use of phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil, tadalafil, vardenafil, or avanafil
3. Constrictive pericarditis when administered via IV route
4. Hypersensitivity to nitroglycerin or any component of the product as well as other nitrates or nitrites
5. Increased intracranial pressure
6. Pericardial tamponade or restrictive cardiomyopathy when administered via IV route
7. Severe anemia

Nitroglycerin should be given to a pregnant woman only if clearly needed

Infant risk cannot be ruled out.

Common: Hypotension, flushing, dizziness, headache, lightheadedness
Serious: Anaphylactoid reaction, methemoglobinemia, raised intracranial pressure

Acute decompensated heart failure:
Continuous IV infusion: Initial 5 to 10 mcg/minute; titrate as needed in increments of 5 to 10 mcg/minute every 3 to 5 minutes up to a maximum of 200 mcg/minute
Acute angina:
Continuous IV infusion: Initial 5 to 10 mcg/minute; titrate as needed in increments of 5 mcg/minute every 5 to 10 minutes up to 20 mcg/minute; if angina persists at a dose of 20 mcg/minute, may increase by 10 to 20 mcg/minute every 3 to 5 minutes to a maximum dose of 400 mcg/minute
Hypertension, perioperative:
Continuous IV infusion: Initial 5 to 10 mcg/minute; increase based on BP response and tolerability in increments of 5 mcg/minute every 3 to 5 minutes up to 20 mcg/minute; if no response at a dose of 20 mcg/minute, may increase by 10 to 20 mcg/minute every 3 to 5 minutes to a maximum dose of 200 mcg/minute.