A student nurse is asked to give an example of a long-acting nitrate. He is correct by saying:
A. Nitroglycerin sublingual
B. Nitroglycerin IV
C. Isosorbide PO
D. Nitroglycerin transmucosal
Correct Answer: C. Isosorbide PO
Isosorbide is one of the most frequently administered long-acting nitrates. PO nitrates are longer acting than IV or SL agents. Other forms of commonly used nitrates include isosorbide dinitrate, isosorbide mononitrate, and isosorbide mononitrate sustained-release (SR). These forms are taken orally and have a longer duration of action.
Option A: Sublingual nitroglycerin is the therapy of choice for acute anginal episodes since it avoids first-pass metabolism, allowing for immediate and short anginal relief. The capsule form of nitroglycerin has a longer duration of action and requires larger doses.
Option B: Intravenous nitroglycerin is useful for hypertensive emergencies. For patients with acute anginal pain, short-acting nitrates are useful for symptom relief.
Option D: Nitroglycerin transmucosal is used for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.