1Nitroglycerin

1STE and NSTE ACS, class I indication in

1 patients with ongoing ischemic

1discomfort, control of hypertension

1or management of pulmonary

1.congestion

Dose

1mg SL, repeated every 5 minutes × 3 doses 0.4 •

1to 10 mcg/minute by continuous infusion 5 •

1Titrated up to 75–100 mcg/minute until relief of symptoms or •

1limiting side-effects (headache or hypotension with a systolic

1blood pressure less than 90 mm Hg or more than 30% below starting

1(mean arterial pressure levels if significant hypertension is present

1Topical patches or oral nitrates are acceptable alternatives for •

1patients without ongoing or refractory symptoms

bClass I recommendations are conditions for which there is evidence and/or general
1.agreement that a given procedure or treatment is useful and effective

1ACS, acute coronary syndrome

1NSTE, non–ST-segment elevation

STE, ST-segment elevatio

Reprinted from Spinler SA, de Denus S. Acute Coronary Syndromes. In: DiPiro JT, Talbert RL, )
:Yee GC, et al, (eds.) Pharmacotherapy: A Pathophysiologic Approach. 6th ed. New York

1(.McGraw-Hill; 2005: 299–302, with permission

95
 PHARMACOTHERAPY

PRINCIPLES & PRACTICE

EDITORS

MARIE A. CHISHOLM-BURNS, PHARMD, FCCP, FASHP

Professor and Head

Department of Pharmacy Practice and Science

The University of Arizona College of Pharmacy

Tucson, Arizona

BARBARA G. WELLS, PHARMD, FASHP, FCCP, BCPP

Professor and Dean

Executive Director, Research Institute of Pharmaceutical Sciences

School of Pharmacy

The University of Mississippi

University, Mississippi
,TERRY L. SCHWINGHAMMER, PHARMD, FCCP, FASHP

BCPS

Professor and Chair

Department of Clinical Pharmacy

West Virginia University

School of Pharmacy

Morgantown, West Virginia

PATRICK M. MALONE, PHARMD, FASHP

Professor and Assistant Dean, Internal Affairs

School of Pharmacy

University of Findlay

Findlay, Ohio

JILL M. KOLESAR, PHARMD, BCPS, FCCP

 Associate Professor

University of Wisconsin School of Pharmacy

Faculty Supervisor

Analytical Instrumentation Laboratory

Madison, Wisconsin

JOHN C. ROTSCHAFER, PHARMD, FCCP

Professor

Department of Experimental and Clinical Pharmacology

College of Pharmacy

University of Minnesota

Minneapolis, Minnesota

JOSEPH T. DIPIRO, PHARMD, FCCP

Professor and Executive Dean

South Carolina College of Pharmacy

 University of South Carolina, Columbia

Medical University of South Carolina

Charleston, South Carolina

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