QuestionSBA
QuestionChoice
Patients are advised to repeat the dose at 5 minutes interval if the pain persists and to call an emergency ambulance if the pain has not gone 5 minutes after taking the second dose
34073
d
He should call an emergency ambulance if the pain has not gone 5 minutes after taking the first dose
QuestionChoice
The correct method of administering GTN is to spray it under the tongue and close the mouth
34071
b
GTN should be sprayed onto the tongue
QuestionChoice
Patients are advised to repeat the dose at 5 minutes interval if the pain persists and to call an emergency ambulance if the pain has not gone 5 minutes after taking the second dose
34072
c
He should repeat the dose at 15 minutes interval if the pain has not gone
QuestionChoice
Glyceryl Trinitrate (GTN) is a medication used for prophylaxis and treatment of angina. Once in the body, It is converted into nitric oxide, an active metabolite that causes vasodilation and increases blood flow to the heart. Headache is a common side effect of all nitrates
34070
a
GTN spray may cause headache
QuestionChoice
GTN does not increase the risk of oral thrush
34074
e
GTN spray may increase risk of oral thrush
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2758
Headache following GTN 
Topic
9
Internal Medicine
6825
Case presentation: A 60-year-old man attends the rapid access chest pain clinic with a two-month history of dull, constricting chest pain that is brought upon by exertion and relieved by rest within 5 minutes. He is currently not in any pain and his resting 12-lead ECG is normal.  

PMH: Hypertension, Hypercholesterolaemia
DH: Amlodipine 5mg PO OD, Simvastatin 40mg ON
One of the medications offered includes a Glyceryl Trinitrate (GTN) spray, which is offered to the patient to relieve episodes of chest pain when they arise.

Question: Select the most important information that should be provided for this patient.
a