Nitroglycerin contraindication: which of the following patient histories is a contraindication?

Nitroglycerin contraindication: which of the following patient histories is a contraindication?

• A. With a systolic blood pressure below 120 mm Hg.
• B. Who have taken up to two doses.
• C. Who have experienced a head injury.
• D. With a history of an ischemic stroke.

Answer: (C)

Nitroglycerin must be avoided in head injury because it can lower blood pressure, and maintaining adequate cerebral perfusion is crucial after head trauma. The vasodilating effect of nitroglycerin reduces systemic BP, which can compromise blood flow to the brain and worsen outcomes if intracranial pathology or bleeding is present. This makes head injury a clear contraindication. The other scenarios aren’t absolute contraindications. A systolic blood pressure being below a threshold isn’t an automatic prohibition—caution is required because nitroglycerin can lower BP further, but whether to give it depends on the individual’s hemodynamics. Receiving up to two doses falls within typical dosing guidelines, so it isn’t a contraindication. A history of ischemic stroke by itself does not automatically forbid nitroglycerin use unless there are other contraindicating conditions.

Nitroglycerin must be avoided in head injury because it can lower blood pressure, and maintaining adequate cerebral perfusion is crucial after head trauma. The vasodilating effect of nitroglycerin reduces systemic BP, which can compromise blood flow to the brain and worsen outcomes if intracranial pathology or bleeding is present. This makes head injury a clear contraindication.

The other scenarios aren’t absolute contraindications. A systolic blood pressure being below a threshold isn’t an automatic prohibition—caution is required because nitroglycerin can lower BP further, but whether to give it depends on the individual’s hemodynamics. Receiving up to two doses falls within typical dosing guidelines, so it isn’t a contraindication. A history of ischemic stroke by itself does not automatically forbid nitroglycerin use unless there are other contraindicating conditions.