How should the nurse instruct the client to administer nitroglycerin spray?

Ask your doctor now for exact instructions on how to use your nitroglycerin and when to call for emergency medical help (911).

Read the Patient Information Leaflet available from your pharmacist. Consult your doctor or pharmacist if you have any questions.

Before using this medication for the first time, spray the pump into the air away from yourself, others, or open flame. This is known as priming the pump. The number of times you need to spray the pump to prime it depends on your brand. If you have not used this medication for 6 weeks or more, you will need to prime it again before use. Do not shake the container.

Sit down before using this medication. Remove the plastic cover. Hold the container upright with your finger on top of the grooved button. Open your mouth, and bring the container as close to your mouth as possible. Press the button to spray the medication onto or under your tongue. Use 1 to 2 sprays as directed by your doctor, then close your mouth. Do not inhale or swallow the spray. Avoid eating, spitting, or rinsing your mouth for 5 to 10 minutes after spraying.

If you are using this medication to prevent chest pain before physical activities, use it 5 to 10 minutes before the activity.

If you are using this medication to relieve chest pain once it occurs, use it as soon as possible. If your chest pain has not improved or if it has worsened 5 minutes after you use this drug, call emergency medical help (911). After calling the emergency number, use another spray. Five minutes after the second spray, if you still have chest pain and the ambulance has not arrived, use a third spray. If your chest pain is not gone after 15 minutes and 3 doses of nitroglycerin, call emergency medical help (911) if you have not called already. Do not use more than 3 sprays during an attack unless directed by your doctor.

Periodically check the level of medication in the container so you know when you need to order more medication.

This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Uses

This medication is used to relieve chest pain (angina) in people that have a certain heart condition (coronary artery disease). It may also be used before physical activities (such as exercise, sexual activity) to help prevent chest pain.

Nitroglycerin belongs to a class of drugs known as nitrates. Angina occurs when the heart muscle is not getting enough blood. This drug works by relaxing and widening blood vessels so blood can flow more easily to the heart.

How To Use

Ask your doctor now for exact instructions on how to use your nitroglycerin and when to call for emergency medical help (911).

Read the Patient Information Leaflet available from your pharmacist. Consult your doctor or pharmacist if you have any questions.

Before using this medication for the first time, spray the pump into the air away from yourself, others, or open flame. This is known as priming the pump. The number of times you need to spray the pump to prime it depends on your brand. If you have not used this medication for 6 weeks or more, you will need to prime it again before use. Do not shake the container.

Sit down before using this medication. Remove the plastic cover. Hold the container upright with your finger on top of the grooved button. Open your mouth, and bring the container as close to your mouth as possible. Press the button to spray the medication onto or under your tongue. Use 1 to 2 sprays as directed by your doctor, then close your mouth. Do not inhale or swallow the spray. Avoid eating, spitting, or rinsing your mouth for 5 to 10 minutes after spraying.

If you are using this medication to relieve chest pain once it occurs, use it as soon as possible. If your chest pain has not improved or if it has worsened 5 minutes after you use this drug, call emergency medical help (911). After calling the emergency number, use another spray. Five minutes after the second spray, if you still have chest pain and the ambulance has not arrived, use a third spray. If your chest pain is not gone after 15 minutes and 3 doses of nitroglycerin, call emergency medical help (911) if you have not called already. Do not use more than 3 sprays during an attack unless directed by your doctor.

If you are using this medication to prevent chest pain before physical activities, use it 5 to 10 minutes before the activity.

Periodically check the level of medication in the container so you know when you need to order more medication.

Side Effects

Headache, dizziness, lightheadedness, nausea, and flushing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Headache is often a sign that this medication is working. Your doctor may recommend treating headaches with an over-the-counter pain reliever (such as acetaminophen, aspirin). If the headaches continue or become severe, tell your doctor promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if these unlikely but serious side effects occur:

  • fainting
  • fast/irregular/pounding heartbeat

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to similar drugs (such as isosorbide mononitrate); or to nitrites; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • recent head injury
  • anemia
  • low blood pressure
  • dehydration
  • other heart problems (such as recent heart attack)

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this medication, especially dizziness and lightheadedness which could increase the risk of falls.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk or if it may harm a nursing infant. Consult your doctor before breast-feeding.

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

  • drugs used to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, tadalafil)
  • certain drugs to treat migraine headaches (ergot alkaloids such as ergotamine)
  • riociguat

This medication may interfere with certain laboratory tests (including blood cholesterol levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips.

Notes

Do not share this medication with others.

Missed Dose

Not applicable.

Storage

Store at room temperature away from light, heat and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Medical Alert

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Information last revised May 2021.

Copyright(c) 2021 First Databank, Inc.

Selected from data included with permission and copyright by First DataBank, Inc. This copyrighted material has been downloaded from a licensed ata provider and is not for distribution, except as may be authorized by the applicable terms of use.

Conditions of use: The information in this database is intended to supplement, not substitute for the expertise and judgment of healthcare professionals. The information in not intend to cover all possible uses, directions, precautions, drug interactions or adverse effects nor should it be construed in indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

How should the nurse instruct the client to administer nitroglycerin spray?

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Which instruction does the nurse provide to the patient for correct application of nitroglycerin?

Inform the patient NOT to swallow or chew the tablet, but let it dissolve under the tongue. In addition, have the patient NOT eat or drink anything for 10-15 minutes after administration. After administration of the first dose, monitor the patient's blood pressure very closely and their chest pain rating.

How is nitroglycerin administered in nursing?

Place sublingual tablets under your tongue or in your cheek; do not chew or swallow the tablet; the tablet should burn or “fizzle” under the tongue. Take the nitroglycerin before chest pain begins, when you anticipate that your activities or situation may precipitate an attack.

Which considerations must the nurse teach the client with nitroglycerin tablet administration?

Patient Teaching & Education Instruct patients to avoid eating or smoking during administration as this may alter absorption. Patients should sit during administration to decrease the risk for injury due to the possibility of hypotension, dizziness, and weakness.

Should nitroglycerin spray be shaken before use?

Do not shake the container. Remove the plastic cover. Before using this medication for the first time, you must prime the bottle by spraying the pump 5 times into the air away from yourself. If this medication has not been used for 6 weeks, you must re-prime the bottle by spraying once into the air away from yourself.