Nitro-Bid (nitroglycerin topical)

Nurses General Nursing

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I tried to look for this in my MedSurg book but couldn't find any information.

What educational materials can you teach someone who is using Nitro-Bid (topical)? Thanks.

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My experience with nitro-bid leaves me with this - "IT SUCKS!" I don't like the fact that the dosing is so uncertain. Your 1 1/2 strip may be way thicker than mine! And it is just a mess sometimes, if you don't get it taped on right. Any teaching information that you would give your pt would pretty much be the same as with any nitro med, exept with nitro-bid you want make sure to rotate the application site, make sure to use the dose measuring papers that come with the ointment. and to appply on a nonhairy area of the skin, don't allow it to come incontact with hands (hard to do as it gets messy sometimes)and do not massage or urb in ointment and it will increase the absorption rate. This is paraphrased from an old Davis's Drug Guide, so you might find more updated information in a newer one. Otherwise check, drugs.com, rx.com, etc. they are other great resources. Hope this helps!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

there are lots of consumer websites that will have good information on them about this. start with

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there are lots of consumer websites that will have good information on them about this. start with

that was the other site i was thinking about! i just couldn't remember it. i was looking all over for the list of websites i used when i was in school and couldn't find it anywhere!

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Specializes in med/surg, telemetry, IV therapy, mgmt.
that was the other site i was thinking about! i just couldn't remember it. i was looking all over for the list of websites i used when i was in school and couldn't find it anywhere!
try these:

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okay just some information that i've gathered about nitroglycerin (all forms)....i have a couple questions...feel free to help me answer it. thanks in advance.

sublingual tablet

-one tablet q 5 minutes...but no more than 3 tablets.

-sit or lie down when taking meds to prevent hypotension

-instruct client to report all attacks

sustained release buccal tablet

-place tablet between lips and gum

-do not place on tongue or drink fluid with it (it will decrease med effect)

-do not chewed or swallowed or crushed

sustained release tablet or capsule

-take on empty stomach with full glass of water

-swallowed whole pill

-it prevents anginal attacks but not intended for immediate relief

translingual spray

-do not shake canister. spray med on or under tongue.

-do not inhale med

-repeat q 5 minutes but no more than 3 sprays

-instruct client to wait 10 seconds before swallowing

transdermal ointment

-take baseline bp and heart rate in sitting position

-rotate sites

-keep ointment container tightly closed and in cool place

-use applicator, spread ointment (the amount of med applied are different in different books/sources---can someone please put down the correct dosage?)

-recheck bp and heart rate again. report measurements to physician.

-assess for redness and pruritis

transdermal unit

-take baseline bp and heart rate in sitting position

-apply patch at the same time each day

-rotate site

-recheck bp and heart rate again. report measurements to physician.

-assess for contact dermatitis

intravenous

-check to make sure client does not have patch or ointment on to prevent overdose

-administer with extreme caution to clients with hypotension and hypovolemia

-monitor for loc

other information

-assess for headache.

-be aware of burning or tingling sensations in sublingual forms

-careful with swimming or bathing with transdermal unit

-remove transdermal unit or ointment and notify md if dizziness occurs following application

-client may use sublingual formulation while on transdermal unit/ointment

-report blurred vision and dry mouth (withdrawal of drug)

-off labeled use for ointment: adjuntive treatment for raynaud's disease

how often should the client ask for a new prescription from the md? every 3 months or 6 months?

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Key teaching point: it will probably give you a headache, so don't be afraid to ask for Tylenol. Putting it on the leg can minimize this.

Also a note to the nurse: don't get it on your hand! Oy, the headache!

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Specializes in Acute Care.
Also a note to the nurse: don't get it on your hand! Oy, the headache!
... gloves solve this problem...
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Specializes in Cardiac Telemetry, ED.

Make sure they know about possible hypotension and to rise slowly, and also to have a nitro free period each day.

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(the amount of med applied are different in different books/sources---can someone please put down the correct dosage?)

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the dr. should have this in his order. it will be in the form of 'inches'. the last resident i had with this med was on 1 1/2 inches of the nitrobid (whatever strength it was - she passed awhile ago) this is what the application sheet is for, it has a 'ruler' on it. always use the applicator.

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good advise here esp educate the patient about the H/A assure them that it is normal and not a bad side-effect

also it is systemic and they do not have to place it directly over the heart, if they feel more secure with it there tell them that the skin does need some rest and to rotate site to avoid rash

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