The side-effect of nitroglycerin is?

Appeared in: SJH Nursing Officer - 2019

Explanation

Nitroglycerin is a potent vasodilator used to treat angina by relaxing smooth muscles in blood vessels.
This widespread vasodilation includes the cerebral (meningeal) arteries in the brain.
The sudden widening of these arteries causes a throbbing headache, which is the most common side effect of the drug.
Other common effects from vasodilation include flushing, dizziness, and orthostatic hypotension (a drop in blood pressure upon standing).

Option A: Vomiting is not a primary or hallmark side effect of nitroglycerin. While nausea can occur, it is much less common than headache.
Option B: Diarrhea is not a recognized side effect of nitroglycerin.
Option D: Constipation is not associated with nitroglycerin. Its mechanism of action (vasodilation) does not typically affect bowel motility in this way.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Adverse effects of Nitroglycerin as background academic context rather than a clinical decision trigger.
Nurses must educate patients that a headache is an expected side effect and often indicates the medication is effective. This reassurance can improve adherence.
A critical nursing action is to instruct patients to sit or lie down before taking sublingual nitroglycerin to prevent injury from falls caused by sudden hypotension and dizziness.
What if the patient has a history of migraines? The nitroglycerin-induced headache can be particularly severe. The nurse should still administer the life-saving drug for angina but be prepared to manage the headache aggressively with prescribed analgesics and a quiet, dark environment.

How to Approach the Question

This is a factual recall question based on pharmacology.
First, identify the drug in the question: Nitroglycerin.
Recall the drug's class and primary mechanism of action. Nitroglycerin is a nitrate, which acts as a potent vasodilator (it widens blood vessels).
Consider the systemic effects of this mechanism. Widespread vasodilation will affect blood vessels throughout the body, not just in the heart.
Evaluate the options based on this mechanism. Dilation of blood vessels in the head (cerebral arteries) would lead to increased pressure and pain, which manifests as a headache.
Eliminate the other options. Vomiting, diarrhea, and constipation are primarily gastrointestinal symptoms and are not directly caused by the vasodilatory action of nitroglycerin.

Concept Tested & Keywords

QFYbmHgHR0GIqPGkZguGrc

E6 Pharmacology Katzung 16e pp. 305-307, 308-310

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 48-50

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