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supplement the dose to as close to 300 mg as possible.
Nitrates are C/I in bradycardia (HR < 50 bpm) due to the patient’s inability to compensate for a
decrease in venous return by increasing HR to improve cardiac output. C.O. = HR x SV
Where this CPG refers to GTN S/L, buccal administration can be substituted if required.
Pain – treat with nitrates and if unresolved, treat with opioids as per CPG A0501 Pain relief. The
intent of analgesia in ACS is to make the patient comfortable. Getting the patient completely painfree
is not always possible and in some cases may be detrimental if excessive opioid doses are
required to achieve it.
Nausea/vomiting – treat as per CPG A0701 Nausea and vomiting
LVF – treat as per CPG A0406 Acute Pulmonary Oedema
Inadequate Perfusion – treat as per CPG A0407 Inadequate Perfusion
Dysrhythmias – see appropriate CPG
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