Nitroglycerin Protocol

Protocol:  Nitroglycerin Use for Cardiac CTAngiogram (CCTA)

Utilization of Nitroglycerin sublingual spray during CCTA

Purpose: To enhance the quality of the images obtained during angiography through coronary vasodilatation

Contraindications

·         Hypersensitivity to organic nitrates, isosorbide, nitroglycerin or any nitroglycerin derivative

·         Concurrent use with any of the following medications in the last 48 hours

Ø  sildenafil (viagra/revatio)

Ø  vardenafil (levitra)

Ø  tadalafil (cialis)

·         Severe aortic valve stenosis

·         Frequent migraine headaches



I.          Spray Nitroglycerin

NOTE:
Advise patient that they are being given a dose of nitroglycerin spray to enhance the quality of the images we are obtaining, and that it may cause temporary dizziness, headache or flushing

1. Spray Nitroglycerin once under patient's tongue and then advise patient to close mouth and not inhale the spray.  Do this just as you are leaving the room prior to beginning the timing bolus scan.

 

3. Monitor HR every one (1) minute and Blood Pressure every 3 minutes.

 

4. If headache occurs, administer Acetaminophen 325 mg times 2 tablets by mouth (for a total of 650mg).