Putting Explosives in Your Mouth
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Putting Explosives in Your Mouth
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Nitroglycerin is a medication used to treat chest pain, reduce cardiac workload, and manage acute pulmonary edema. It is also, somewhat inconveniently, an actual explosive.
In this episode of That Paramedic Podcast, we explore how nitroglycerin went from blowing things up to becoming one of the most recognizable medications in emergency medicine. We break down what nitro does to the cardiovascular system, including its effects on preload, afterload, coronary blood flow, and myocardial oxygen demand.
We also discuss common indications, dosing considerations, contraindications, adverse effects, and the clinical situations where nitroglycerin can be extremely helpful or spectacularly unhelpful. Along the way, we examine hypotension, right ventricular infarctions, PDE-5 inhibitors, pulmonary edema, and why giving nitro involves considerably more thought than simply asking whether the patient has chest pain.
It is cardiovascular physiology, explosives, questionable humour, and practical prehospital medicine, all packed into one episode.