Which medication is ordered for chest pain and administered sublingually?

Which medication is ordered for chest pain and administered sublingually?

• A. Aspirin
• B. Albuterol
• C. Nitroglycerin
• D. Morphine

Answer: (C)

Nitroglycerin is used for chest pain because it rapidly relieves myocardial ischemia by dilating blood vessels. As a nitrate, it releases nitric oxide, which relaxes vascular smooth muscle. This dilation lowers venous return (preload) and, to a lesser extent, dilates arteries, reducing the heart’s workload and oxygen demand while potentially increasing coronary blood flow. Administering it sublingually lets it be absorbed directly into the bloodstream, bypassing the liver and producing a quick onset of action—usually within a few minutes. A common approach is a small sublingual dose under the tongue, with repeat doses every five minutes up to three doses if pain persists, while monitoring blood pressure and symptoms. It’s important to watch for hypotension and headaches, and nitroglycerin should be avoided in people taking certain medications (like PDE5 inhibitors) or when blood pressure is very low. Other choices have different targets: aspirin is an antiplatelet given to help prevent clot progression (often chewed and swallowed rather than sublingually); albuterol is a bronchodilator for airway constriction; morphine is an analgesic used for chest pain when needed but not given sublingually as a standard rapid-relief measure.

Nitroglycerin is used for chest pain because it rapidly relieves myocardial ischemia by dilating blood vessels. As a nitrate, it releases nitric oxide, which relaxes vascular smooth muscle. This dilation lowers venous return (preload) and, to a lesser extent, dilates arteries, reducing the heart’s workload and oxygen demand while potentially increasing coronary blood flow. Administering it sublingually lets it be absorbed directly into the bloodstream, bypassing the liver and producing a quick onset of action—usually within a few minutes.

A common approach is a small sublingual dose under the tongue, with repeat doses every five minutes up to three doses if pain persists, while monitoring blood pressure and symptoms. It’s important to watch for hypotension and headaches, and nitroglycerin should be avoided in people taking certain medications (like PDE5 inhibitors) or when blood pressure is very low.

Other choices have different targets: aspirin is an antiplatelet given to help prevent clot progression (often chewed and swallowed rather than sublingually); albuterol is a bronchodilator for airway constriction; morphine is an analgesic used for chest pain when needed but not given sublingually as a standard rapid-relief measure.