Nitroglycerin precautions include which of the following?

• A. Pregnancy category C
• B. Obtain IV access prior to administration
• C. Avoid in suspected intracranial hemorrhage or increased intracranial pressure
• D. All of the above

Answer: (D)

Nitroglycerin’s safety profile hinges on its vasodilating effects and the potential for rapid hemodynamic changes in vulnerable patients. In pregnancy, it is categorized as category C, meaning fetal risk cannot be ruled out and the drug should be used only if the potential benefit justifies the risk. In acute settings, obtaining IV access before giving an IV nitro infusion is standard so you can monitor blood pressure closely and have access to administer fluids or other therapies if needed. Finally, in patients with suspected intracranial hemorrhage or increased intracranial pressure, nitroglycerin is avoided because further vasodilation can raise intracranial blood volume and pressure, potentially worsening brain edema or bleeding and reducing cerebral perfusion pressure. Together, these points explain why all of the above are precautions for nitroglycerin use.