Indication
Acute pulmonary oedema, hypertensive emergency, ACS pain.
Preparation
50 mg in 250 mL D5W or NS (200 mcg/mL). Use non-PVC tubing.
Dilution
50 mg / 250 mL → 200 mcg/mL
Rate
Start 5–10 mcg/min; titrate by 5 mcg/min q5min; usual 10–200 mcg/min.
Monitoring
- • Continuous BP
- • HR
- • Symptoms (chest pain, dyspnoea)
Common errors
- • Use in RV infarction → profound hypotension
- • Concurrent PDE-5 inhibitor
Pearls
- • Tachyphylaxis after 24–48 h — plan nitrate-free interval
