Name a key contraindication to nitroglycerin administration in ICEMA standing orders.

Name a key contraindication to nitroglycerin administration in ICEMA standing orders.

• A. Systolic blood pressure below the threshold (hypotension) or recent use of phosphodiesterase inhibitors.
• B. Allergy to aspirin.
• C. History of asthma.
• D. Hypoglycemia.

Answer: (A)

Nitroglycerin works by dilating veins and arteries, which lowers preload and blood pressure while reducing myocardial oxygen demand. Because of this, two situations make its use unsafe under standing orders: low systolic blood pressure and recent use of phosphodiesterase inhibitors. If the blood pressure is already too low, additional vasodilation can cause dangerous drops in perfusion. PDE-5 inhibitors (such as sildenafil, tadalafil, or similar drugs) markedly amplify nitroglycerin’s effect, risking life-threatening hypotension. The other options don’t pose the same direct safety risk with nitroglycerin: an aspirin allergy doesn’t stop nitroglycerin, asthma history isn’t a contraindication, and hypoglycemia isn’t a contraindication to nitroglycerin itself (though hypoglycemia would be treated first if present).

Nitroglycerin works by dilating veins and arteries, which lowers preload and blood pressure while reducing myocardial oxygen demand. Because of this, two situations make its use unsafe under standing orders: low systolic blood pressure and recent use of phosphodiesterase inhibitors. If the blood pressure is already too low, additional vasodilation can cause dangerous drops in perfusion. PDE-5 inhibitors (such as sildenafil, tadalafil, or similar drugs) markedly amplify nitroglycerin’s effect, risking life-threatening hypotension. The other options don’t pose the same direct safety risk with nitroglycerin: an aspirin allergy doesn’t stop nitroglycerin, asthma history isn’t a contraindication, and hypoglycemia isn’t a contraindication to nitroglycerin itself (though hypoglycemia would be treated first if present).