If SBP falls below the threshold after nitroglycerin administration, what is the appropriate action?

• A. Discontinue nitroglycerin and reassess.
• B. Continue nitroglycerin and increase dose.
• C. Switch to oral nitroglycerin.
• D. Ignore and proceed.

Answer: (A)

Nitrates such as nitroglycerin can lower blood pressure by dilating veins and reducing preload. If the systolic blood pressure falls below the safety threshold after administering nitroglycerin, the correct action is to discontinue the drug and reassess the patient. This protects perfusion to vital organs and allows you to check for other causes of hypotension or signs of ongoing ischemia. Continuing or increasing the dose would worsen hypotension and risk further harm. Switching to an oral form isn’t appropriate in an acute setting due to slower onset and persistent BP effects, and ignoring the drop is unsafe.