
(1)
To determine:
For each patient, state the rationale for the route or form of the drug that was chosen. Which forms have immediate action? Why would this be important?
Case summary:
Four patients with angina are receiving a form of nitro-glycerine, as follows:
Mrs. A. takes 9 mg PO twice a day to prevent angina. Mr. B. takes a transdermal patch that delivers 0.2 mg/hr, also to prevent angina. Mrs. C. takes 0.4 mg sublingually, only if needed for chest pain. Mr. D. is in the hospital with severe, unstable angina and is receiving 20 mcg/hr via an intravenous infusion.
(2)
To determine:
Which form or forms are most affected by the first-pass effect? Explain your answer.
Case summary:
Four patients with angina are receiving a form of nitro-glycerine, as follows:
Mrs. A. takes 9 mg PO twice a day to prevent angina. Mr. B. takes a transdermal patch that delivers 0.2 mg/hr, also to prevent angina. Mrs. C. takes 0.4 mg sublingually, only if needed for chest pain. Mr. D. is in the hospital with severe, unstable angina and is receiving 20 mcg/hr via an intravenous infusion.
(3)
To determine:
What would happen if Mrs. A. chewed her nitro-glycerine dose? If Mrs. C. chewed her nitro-glycerine dose?
Case summary:
Four patients with angina are receiving a form of nitro-glycerine, as follows:
Mrs. A. takes 9 mg PO twice a day to prevent angina. Mr. B. takes a transdermal patch that delivers 0.2 mg/hr, also to prevent angina. Mrs. C. takes 0.4 mg sublingually, only if needed for chest pain. Mr. D. is in the hospital with severe, unstable angina and is receiving 20 mcg/hr via an intravenous infusion.

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