Question: If we are treating a patient with acute cardiogenic pulmonary edema that is a nitro virgin that's blood pressure is above 140 systolic and then their blood pressure drops below 140 systolic but not by one third then can we consider them now as not being a nitro virgin and therefore continue treating them with 0.4 nitro? Thank you for taking the time to answer all of these questions.
Thanks for your question. One of the conditions to administer NTG to a patient in pulmonary edema who has not received NTG previously is that the systolic blood pressure must be greater than 140mmHg. In the case you describe above, if the blood pressure falls below 140mmHg, then the patient does not qualify for NTG. Administration of NTG during the same patient contact does not constitute previous authorized use (plus it dropped their blood pressure already).