Emergency NitroQuick for others?



O

Owen Lowe

Guest
Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I am.
It occurred to me recently while on the treadmill at my fitness center that if the guy or gal next
to me went down and complained of the "classic" chest discomfort I might be able to help alleviate
heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is this
something to offer? Are there serious side affects for someone who turns out later to not have
suffered a heart incident? What if the person is unconscious? Or in need of CPR - a nitroQ under the
tongue and continue with the chest presses?

Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
possibly life and death different?
 
"Owen Lowe" <[email protected]> wrote in message
news:[email protected]...
> Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I
> am. It occurred to me recently while on the treadmill at my fitness center that if the guy or gal
> next to me went down and complained of the "classic" chest discomfort I might be able to help
> alleviate heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is
> this something to offer? Are there serious side affects for someone who turns out later to not
> have suffered a heart incident? What if the person is unconscious? Or in need of CPR - a nitroQ
> under the tongue and continue with the chest presses?
>
> Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
> possibly life and death different?

I won't comment on giving it to someone else. I really don't know.

I think the first thing for yourself and others as far as medication in such a situation is to chew
an aspirin.

I've been told flat out by a cardiologist (not mine) that nitro does no good if you are having a
heart attack - i.e. it is only good for pain relief. I'm suspicious of this because 1. Even if it
does not relieve the blockage it may expand the collaterals thus reducing the damage. 2. One of the
first things they do when you go to the hospital with a suspected MI is put you on a nitro drip.

So I'd be interested in other views also.

Bill
 
"Owen Lowe" <[email protected]> wrote in message
news:[email protected]...
> Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I
> am. It occurred to me recently while on the treadmill at my fitness center that if the guy or gal
> next to me went down and complained of the "classic" chest discomfort I might be able to help
> alleviate heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is
> this something to offer? Are there serious side affects for someone who turns out later to not
> have suffered a heart incident? What if the person is unconscious? Or in need of CPR - a nitroQ
> under the tongue and continue with the chest presses?
>
> Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
> possibly life and death different?

First of all, carrying nitro in your pocket at the gym might not be such a good thing. It is heat
sensitive and doesn't last very long. While you are working out, I might set the container elsewhere
to prevent it from overheating.

Nitro only lasts a few minutes. It can cause a serious drop in blood pressure which is why it is
always a good idea to sit down or lie down after taking it. The main danger of this is falling.

If someone is unconscious or in need of CPR, I wouldn't give them a nitro. If they complained of
classic, crushing chest pain, it might very well help. However, I wonder if the Good Samaritan laws
would cover an unlicensed person giving someone prescription meds. I think you would be at serous
risk. I, personally, would not do it.

I don't know where you live. In my town, we have excellent EMS services. The average time from
calling 911 to having personnel on site is five minutes. The fire dept often shows up before they do
and they keep nitro in their little red boxes. Five minutes seems like a lifetime in such a
situation but if good CPR is administered, it isn't too long to wait.

j
 
news:nSg%[email protected]...
>
> "Owen Lowe" <[email protected]> wrote in message news:noemail-
> [email protected]...
> > Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I
> > am. It occurred to me recently while on the treadmill at my fitness center that if the guy or
> > gal next to me went down and complained of the "classic" chest discomfort I might be able to
> > help alleviate heart damage by giving them a tablet of my Nitro - after 911 was called, of
> > course. Is this something to offer? Are there serious side affects for someone who turns out
> > later to not have suffered a heart incident? What if the person is unconscious? Or in need of
> > CPR - a nitroQ under the tongue and continue with the chest presses?
> >
> > Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
> > possibly life and death different?
>
> I won't comment on giving it to someone else. I really don't know.
>
> I think the first thing for yourself and others as far as medication in
such a
> situation is to chew an aspirin.
>
> I've been told flat out by a cardiologist (not mine) that nitro does no
good
> if you are having a heart attack - i.e. it is only good for pain relief.
I'm
> suspicious of this because 1. Even if it does not relieve the blockage it
may
> expand the collaterals thus reducing the damage. 2. One of the first
things
> they do when you go to the hospital with a suspected MI is put you on a
nitro
> drip.
>
> So I'd be interested in other views also.
>
> Bill
>

I think what your cardiologist means is that nitro will help chest pain related to angina by
expanding the artery to allow for greater blood flow. It will not help once the artery is fully
occluded as in a heart attack. So, while you might experience relief with a 95 percent blockage, it
will not help a total occlusion.

j
 
Owen Lowe wrote:

> Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I
> am. It occurred to me recently while on the treadmill at my fitness center that if the guy or gal
> next to me went down and complained of the "classic" chest discomfort I might be able to help
> alleviate heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is
> this something to offer?

No.

> Are there serious side affects for someone who turns out later to not have suffered a heart
> incident?

Yes.

> What if the person is unconscious? Or in need of CPR - a nitroQ under the tongue and continue with
> the chest presses?
>

No.

>
> Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
> possibly life and death different?

Nitroglycerin should only be administered per a doctor's instructions.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

**
Who is the humblest person in the universe?
http://makeashorterlink.com/?W1F522557

What is all this about?
http://makeashorterlink.com/?T13943F77

Is this spam?
http://makeashorterlink.com/?N69721867
 
On Wed, 25 Feb 2004 22:01:28 -0800, Owen Lowe
<[email protected]> wrote:

>Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I am.
>It occurred to me recently while on the treadmill at my fitness center that if the guy or gal next
>to me went down and complained of the "classic" chest discomfort I might be able to help alleviate
>heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is this
>something to offer? Are there serious side affects for someone who turns out later to not have
>suffered a heart incident? What if the person is unconscious? Or in need of CPR - a nitroQ under
>the tongue and continue with the chest presses?
>
>Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
>possibly life and death different?

Owen,

Thank you for posting this query. I was just about to ask the same question myself. Following my
quad CAB a couple of years ago I have always carried a GTN spray with me. I have taken on board the
point made in Julianne's reply, concerning deterioration of GTN with elevated storage temperature.

Finally, Andrew Chung's unequivocal "No" is all th guidance that I need. Thank you Andrew.

Peter
 
On 26-Feb-2004, Owen Lowe <[email protected]> wrote:

> Hi all. I routinely carry a small vial of 0.4mg nitroglycerine in my pocket - no matter where I
> am. It occurred to me recently while on the treadmill at my fitness center that if the guy or gal
> next to me went down and complained of the "classic" chest discomfort I might be able to help
> alleviate heart damage by giving them a tablet of my Nitro - after 911 was called, of course. Is
> this something to offer?

yes.

> Are there serious side affects for someone who turns out later to not have suffered a heart
> incident?

no. however, nitro carries the risk of causing hypotension since it dilates all arteries, not just
the coronary arteries. nitro will also relax smooth muscle in the esophagus, so it can alleviate
chest pain from esophageal spasm, and erroneously be interpreted as cardiogenic chest pain
alleviated with nitro.

>What if the person is unconscious?

don't give it.

>Or in need of CPR - a nitroQ under the tongue and continue with the chest presses?

the blood pressure is too low anyway, and nitro would make things worse.

>
> Ordinarily I'd never share prescription meds with anyone, but this seems a little different -
> possibly life and death different?

I don't think it would be a life or death situation, but one of saving cardiac muscle and minimizing
damage if indeed coronary flow is impaired acutely.

--
Winning against heart attack and stroke http://www.sonoscore.com
 
In article <pln%b.2476$PY.155@lakeread05>,
"Julianne" <[email protected]> wrote:

> First of all, carrying nitro in your pocket at the gym might not be such a good thing. It is heat
> sensitive and doesn't last very long. While you are working out, I might set the container
> elsewhere to prevent it from overheating.

I usually take it out of my pocket for my running - even that little bottle seems to get annoying
after a while. I also toss the bottle after 6 months and replace it with a new one just for the
heat issue.

> Nitro only lasts a few minutes. It can cause a serious drop in blood pressure which is why it is
> always a good idea to sit down or lie down after taking it. The main danger of this is falling.
>
> If someone is unconscious or in need of CPR, I wouldn't give them a nitro. If they complained of
> classic, crushing chest pain, it might very well help. However, I wonder if the Good Samaritan
> laws would cover an unlicensed person giving someone prescription meds. I think you would be at
> serous risk. I, personally, would not do it.

Yes, on further thought, I think you're right in this regard.

> I don't know where you live. In my town, we have excellent EMS services. The average time from
> calling 911 to having personnel on site is five minutes. The fire dept often shows up before they
> do and they keep nitro in their little red boxes. Five minutes seems like a lifetime in such a
> situation but if good CPR is administered, it isn't too long to wait.

We seem to have excellent response times as well - plus the town's small and the hospital's fairly
centrally located.

Thanks Juliane for the thoughtful post - I believe I recall reading your posts on one of the diet
groups months back (you're a nurse, right? and you once posted about an obese patient who died from
lack of family caring?) - I always found your advice and commentary helpful and informative.
 
In article <[email protected]>,
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:

> Nitroglycerin should only be administered per a doctor's instructions.

I guess I thought as much, but just didn't know if the harm would be greater than the good for a
layperson to administer.
 
"Owen Lowe" <[email protected]> wrote in message
news:[email protected]...
> In article <pln%b.2476$PY.155@lakeread05>,
> "Julianne" <[email protected]> wrote:
>
> > First of all, carrying nitro in your pocket at the gym might not be such
a
> > good thing. It is heat sensitive and doesn't last very long. While
you
> > are working out, I might set the container elsewhere to prevent it from overheating.
>
> I usually take it out of my pocket for my running - even that little bottle seems to get annoying
> after a while. I also toss the bottle after 6 months and replace it with a new one just for the
> heat issue.
>
> > Nitro only lasts a few minutes. It can cause a serious drop in blood pressure which is why it is
> > always a good idea to sit down or lie down
after
> > taking it. The main danger of this is falling.
> >
> > If someone is unconscious or in need of CPR, I wouldn't give them a
nitro.
> > If they complained of classic, crushing chest pain, it might very well
help.
> > However, I wonder if the Good Samaritan laws would cover an unlicensed person giving someone
> > prescription meds. I think you would be at serous risk. I, personally, would not do it.
>
> Yes, on further thought, I think you're right in this regard.
>
> > I don't know where you live. In my town, we have excellent EMS
services.
> > The average time from calling 911 to having personnel on site is five minutes. The fire dept
> > often shows up before they do and they keep
nitro in
> > their little red boxes. Five minutes seems like a lifetime in such a situation but if good CPR
> > is administered, it isn't too long to wait.
>
> We seem to have excellent response times as well - plus the town's small and the hospital's fairly
> centrally located.
>
> Thanks Juliane for the thoughtful post - I believe I recall reading your posts on one of the diet
> groups months back (you're a nurse, right? and you once posted about an obese patient who died
> from lack of family caring?) - I always found your advice and commentary helpful and informative.

You're welcome. Thank you for the kind words!

j