Sublingual nitroglycerin (Nitrostat) is indicated for the relief of an acute angina attack. One sublingual tablet should be used at the first sign of an acute attack. Up to two additional doses can be taken at 5 minute intervals if relief is not seen.
In the past, patients have been counseled to contact EMS if angina is still not relieved after 3 doses. However, the American College of Cardiology and the American Heart Association revised these recommendations in 2004, recognizing that delay in seeking medical attention (as may occur during this 15 minute span) may adversely affect patient survival. The updated recommendations state that patients should contact EMS if there is no relief after just one dose of sublingual nitroglycerin. Patients should continue to use the second and third doses, if needed, while waiting for EMS to arrive. Patients are also encouraged to wait for an ambulance rather than having family or friends provide transportation to the hospital, so that they may be treated en route if necessary.
Further counseling points regarding sublingual nitroglycerin include:
The same recommendations also apply to nitroglycerin lingual spray (e.g. Nitrolingual, NitroMist). An important note about the spray is that it must be "primed" with one spray before being used for the first time, and must be reprimed if not used for 6 weeks.
|I've been on it twice. Once when I was 23 and about to graduate from cgoelle, and another time when I was 25 and about to end a paid volunteer position in Colorado. In both cases I saw a psychologist in addition to getting medication. For me it helped turn the volume down on my emotions so I could work on being a more balanced person on my own. I've also had a long fear of being dependent on medication (one of the reasons I've avoided Xanax, as it's known to be habit forming), but at this point, I've been without meds long enough to know that it won't be a problem.From what I've read, it usually is a balance of chemical and psychological problems that leads to clinical depression. So it can be kind of a chicken and egg question about which started which. I think that's why drugs are often combined with therapy. One is for the chemical side; the other is for the psychological side.I'm no expert on this so take it with a grain of salt. A natural approach may be just what you need.
Posted 8/5/2012 05:00:25 PM
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