If CPAP is already in place for a patient, how should nitroglycerin be administered?

Administering nitroglycerin in the form of a nitro paste is appropriate for patients who are already receiving CPAP (Continuous Positive Airway Pressure) therapy. CPAP is often used for patients in respiratory distress, particularly in conditions like congestive heart failure or severe asthma, where maintaining airway pressure is crucial.

Using nitro paste allows for a controlled and gradual absorption of the medication. This method minimizes the risk of hypotension or further respiratory complications, which can occur if nitroglycerin is administered sublingually or via inhalation. These routes might lead to a rapid onset of action, potentially dropping blood pressure too quickly in a patient who is already hemodynamically compromised due to the respiratory distress.

In contrast, an IV injection may not be feasible or necessary in a patient already benefiting from CPAP, as this could complicate their management or overwhelm their system with too rapid a response. Sublingual administration also poses risks for the same reasons, with the potential for rapid hypotensive effects. Inhalation of nitroglycerin, while a method explored in some contexts, is not standard practice and could compromise the effectiveness of CPAP.

Choosing nitroglycerin paste safely delivers the medication while taking into account the patient's existing