What is the correct instruction for using nitroglycerin sublingual spray during angina?

What is the correct instruction for using nitroglycerin sublingual spray during angina?

• A. Spray under the tongue at 5-minute intervals. Continue the procedure until the pain subsides.
• B. Spray under the tongue. If pain continues, spray an additional time for better absorption.
• C. Spray under the tongue. If the pain is not relieved, apply a nitroglycerin patch to the skin to help facilitate the action of the spray.
• D. Spray once under the tongue at 5-minute intervals to a maximum of three times. If the pain continues, seek medical attention.

Answer: (D)

Using nitroglycerin spray for acute angina relies on rapid absorption through the under-tongue tissues and a clear dosing limit, plus knowing when to seek urgent care. Start with one spray under the tongue and let it absorb without swallowing or chewing. After five minutes, assess relief. If pain persists, repeat once, and you may repeat again for a total of up to three sprays in fifteen minutes. If the third spray does not relieve the pain, seek emergency medical care promptly, as ongoing chest pain could indicate a heart attack or another serious condition. This approach provides rapid relief while preventing excessive dosing that could cause dangerous drops in blood pressure and delays in seeking additional help.

Using nitroglycerin spray for acute angina relies on rapid absorption through the under-tongue tissues and a clear dosing limit, plus knowing when to seek urgent care. Start with one spray under the tongue and let it absorb without swallowing or chewing. After five minutes, assess relief. If pain persists, repeat once, and you may repeat again for a total of up to three sprays in fifteen minutes. If the third spray does not relieve the pain, seek emergency medical care promptly, as ongoing chest pain could indicate a heart attack or another serious condition. This approach provides rapid relief while preventing excessive dosing that could cause dangerous drops in blood pressure and delays in seeking additional help.