Question

The administration of nitroglycerin by an EMT requires direction from medical control or a standing order, but which of these should you immediately note as a contraindication for the administration of this drug?

A. patient diagnosed with angina
B. patient taking medication for erectile dysfunction
C. patient with systolic blood pressure over 100
D. patient reports burning sensation under the tongue with previous administrations

Answer 1

The administration of nitroglycerin to a patient taking medication for erectile dysfunction, such as sildenafil, is a contraindication due to the risk of severe hypotension caused by combined vasodilation effects.

Step-by-step explanation:

When administering nitroglycerin as a treatment for myocardial infarction (MI) or chest pain due to angina, an EMT must keep in mind several contraindications. Nitroglycerin is known to be a vasodilator, which through the release of nitric oxide, helps to relax the smooth muscles in the coronary vessels, improving blood flow to the heart.

However, patients currently taking medication prescribed for erectile dysfunction (ED), such as PDE5 inhibitors including sildenafil (Viagra®), are at risk when given nitroglycerin because of the combined effect that could lead to dangerous drops in blood pressure. Therefore, a patient taking medication for erectile dysfunction would be considered to have an immediate contraindication for the administration of nitroglycerin by an EMT.