Explain why nitroglycerine is usually not given orally and why different routes of administration are utilized. What effect do the different routes of administration have on the bioavailability of the drug?
Explain why nitroglycerine is usually not given orally
Prompt for Discussion: Explain why nitroglycerine is usually not given orally and why different routes of administration are utilized. What effect do the different routes of administration have on the bioavailability of the drug?
Description of discussion: Impact of Pharmacokinetics on Medication Selection and Administration As an advanced practice nurse, you will likely be responsible for selecting and prescribing pharmaceuticals to address your patients’ health needs and concerns. To what extent is understanding the pharmacokinetics of a certain medication important in your decision-making process when prescribing a medication for your patient?
Knowing the pharmacokinetic effects of medications—such as how long will the medication be absorbed and exert an effect on the body before it is eliminated—can have important implications for addressing your patient’s health needs. For this Discussion, think about the types of decisions you might make, with an understanding of pharmacokinetics, when prescribing medications for your patients. Reflect on how having a working knowledge of pharmacokinetics of medications is important in your role as an advanced practice nurse.
Nitroglycerin Sublingual
Nitroglycerin sublingual tablets are used to treat episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). It is also used just before activities that may cause episodes of angina in order to prevent the angina from occurring. Nitroglycerin is in a class of medications called vasodilators. It works by relaxing the blood vessels so the heart does not need to work as hard and therefore does not need as much oxygen.
Nitroglycerin comes as a sublingual tablet to take under the tongue. The tablets is usually taken as needed, either 5 to 10 minutes before activities that may cause attacks of angina or at the first sign of an attack. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nitroglycerin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.Nitroglycerin may not work as well after you have used it for some time or if you have taken many doses.
Take the fewest tablets needed to relieve the pain of your attacks. If your angina attacks happen more often, last longer, or become more severe at any time during your treatment, call your doctor.Talk to your doctor about how to use nitroglycerin tablets to treat angina attacks. Your doctor will probably tell you to sit down and take one dose of nitroglycerin when an attack begins. If your symptoms do not improve very much or if they worsen after you take this dose you may be told to call for emergency medical help right away.
If your symptoms do not go away completely after you take the first dose, your doctor may tell you to take a second dose after 5 minutes have passed and a third dose 5 minutes after the second dose. Call for emergency medical help right away if your chest pain has not gone away completely 5 minutes after you take the third dose.Do not chew, crush, or swallow nitroglycerin sublingual tablets.
Instead, place the tablet under your tongue or between your cheek and gum and wait for it to dissolve. You may feel burning or tingling in your mouth as the tablet dissolves. This is normal but is not a sign that the tablet is working. Do not be concerned that the tablet is not working if you do not feel the burning or tingling.
Hence in emergency, GTN is administered sublingually
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