Lecture on Important Vasodilators

Nitroprusside

• Usage: Used in hypertensive crisis.
• Mode of Action: Causes direct vasodilation of arteries and veins, rapidly reducing blood pressure.
• Effects: Reduces both preload and afterload.
• Key Side Effects:
  • Hypotension (can cause dangerous drop in BP; black box warning)
  • Cyanide toxicity
  • Thiocyanate toxicity
  • Dizziness
  • Gastrointestinal (GI) upset
• Mnemonic: Nitroprusside may “pruss” you into the ground (press you into the ground) = severe hypotension.
• Interventions for hypotension:
  • Raise patient’s legs
  • Decrease nitroprusside dose
  • Increase fluids
  • Refer to facility policy for specific actions

Medications for Angina

• Medications: Nitroglycerin, Isosorbide Mononitrate, Isosorbide Dinitrate
• Mode of Action: Vasodilation, decreases preload, reduces myocardial oxygen demand.
• Key Side Effects:
  • Orthostatic hypotension
  • Headache
  • Reflex tachycardia
• Mnemonic: Isosorbide medications = eating icy sorbet = headache due to cold = headache as side effect.
• Usage Instructions for Sublingual Nitroglycerin:
  • Store in a cool, dark place.
  • For chest pain:
    1. Place 1 tablet under the tongue. Wait 5 minutes.
    2. If pain persists, call 911. Place 2nd tablet, wait 5 minutes.
    3. If still no relief, place 3rd tablet. No more than 3 tablets.
• Topical Nitroglycerin Application:
  • Wear gloves to avoid absorbing medication.
  • Remove prior dose before applying new one.
  • Rotate application sites.
  • Choose clean, hairless area for application.
  • General rule: always wear gloves in patient’s room.

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• Topic: Antidysrhythmic medications

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