What is a contraindication to nitrate administration ACLS?

What is a contraindication to nitrate administration ACLS?

Nitrates should not be used in patients presenting with marked hypotension or bradycardia, or if there is suspicion of right ventricular infarction.

What are the contraindications for nitrates?

Contraindications

• Allergy to nitrates.
• Concomitant use of phosphodiesterase (PDE) inhibitors such as tadalafil and sildenafil.
• Right ventricular infarction.
• Hypertrophic cardiomyopathy.

Is Nitro contraindicated in inferior MI?

Nitroglycerin is also contraindicated in the setting of an inferior MI with right ventricular involvement because, in this specific situation, the heart is dependent on preload.

What are the 5 contraindications of nitroglycerin?

Contraindications of nitroglycerin

• Have a known sensitivity to nitrate medications.
• Have taken erectile dysfunction medications within the past 24 hours, such as Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil or vardenafil.
• Are hypotensive (typically <90 SBP or <65 MAP)

What drug is used for asystole?

The only two drugs recommended or acceptable by the American Heart Association (AHA) for adults in asystole are epinephrine and vasopressin.

Do you give nitrates for stemi?

NSTEMI and STEMI AHA/ACC guidelines recommend administration of sublingual or intravenous nitrates for management of angina, hypertension, acute pulmonary edema, or recurrent ischemia as a class I indication [5,7].

Who should not get nitrates?

You shouldn’t take nitrates if you: Had severe allergic reactions to medicines with nitroglycerin or isosorbide. Take some erectile dysfunction drugs such as Cialis (tadalafil), Levitra (vardenafil), or Viagra (sildenafil). Have narrow-angle glaucoma.

Why do nitrates cause tachycardia?

At higher doses, the vasodilator effect is exerted on arteries and, although it reduces peripheral vascular resistance (afterload) and blood pressure, it can also produce reflex tachycardia which annihilates the reduction of MVO2. Finally, nitrates exert anti-platelet aggregation effects.

Why nitrates are contraindicated in inferior wall MI?

Thus, in the setting of an inferior AMI, a marked hypotensive response to nitrates suggests the presence of RV involvement. Moreover, hypotension after nitrate administration may be anticipated in patients with known RV infarction, and in such patients, nitrates should be administered carefully.

Why does inferior wall MI cause hypotension?

Approximately 40% of inferior wall infarctions also involve the right ventricle. Right ventricular infarctions are very pre-load dependent, and nitrates may precipitate a drop in blood pressure.

Are there any contraindications to nitrate therapy?

Contraindications to Nitrate Administration 1 Right ventricular infarction in which the patient is critically dependent… 2 Viagra and other phosphodiesterase inhibitors within 24 hours (48 hours for tadalafil). 3 Systolic blood pressure 30 mm Hg less than usual. 4 Systolic blood pressures less than 90 mm Hg. 5 Severe bradycardia.

Are there any contraindications to nitrate in Viagra?

Contraindications to Nitrate Administration. Viagra and other phosphodiesterase inhibitors within 24 hours (48 hours for tadalafil). Nitrates and these agents share a common mechanism of action in facilitating the release of nitric oxide. Both clases of agent also increase cyclic guanosine monophosphate (cGMP) .

When to take nitrate for right ventricular infarction?

Contraindications to Nitrate Administration. Right ventricular infarction in which the patient is critically dependent upon preload for RV filling and cardiac output. Viagra and other phosphodiesterase inhibitors within 24 hours (48 hours for tadalafil).

Are there any contraindications to the use of nitroglycerin?

The current 2014 ACC/AHA NSTEMI and 2013 ACC/AHA STEMI Guidelines as well as the 1999 ACC/AHA Expert Consensus Document all support the following to be contraindications to the use of any form of nitroglycerin include: Hypotension (usually reported to be a systolic blood pressure < 90 mm Hg) or a > 30 mm Hg drop from the patient’s baseline