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IV nitroglycerine alternatives

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Contents

1 Background
- 1.1 Nitroglycerine Bioavailability
2 Suggested Substitutions^[3]
3 See Also
4 References

Background

Suggestions for substitution during the IV shortage

Nitroglycerine Bioavailability

Oral ^[1]: <1%
Sublingual ^[1]: 38% (15-40%)
Topical ^[1]: 72%

Half-life^[2]: 0.05 h

Suggested Substitutions^[3]

Sublingual nitroglycerin, 1-2 tabs or sprays every 5 minutes as needed
- Once controlled
  - Nitroprusside OR Isordil PO (nitro paste or longer acting NTG)
- If not well controlled
  - IV enalapril 0.625-1.25mg IV bolus
  - IV hydralazine 5-10mg IV bolus
  - IV nitroprusside

See Also

References

Authors

Ross Donaldson, Neil Young, Daniel Ostermayer

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Pharmacology