NREMT Emergency Medical Technician (EMT) Cognitive ExamPharmacologyMedium

A 50-year-old male is experiencing severe chest pain. He has a history of hypertension and takes prescribed medication for it. You administer sublingual nitroglycerin as per protocol. Approximately 2 minutes later, he complains of a headache. What is the most likely cause of this headache?

  1. AA common side effect of nitroglycerin's vasodilatory action.
  2. BAn allergic reaction to the nitroglycerin.
  3. CAnxiety related to his cardiac event.
  4. DA sudden increase in his blood pressure.
Show answer & explanation

Correct answer: A. A common side effect of nitroglycerin's vasodilatory action.

Nitroglycerin causes widespread vasodilation, including in the cerebral blood vessels. This dilation leads to increased blood flow to the brain and can cause a headache, which is a very common and expected side effect.

Why the other options are wrong

  • B. An allergic reaction would typically present with symptoms like rash, itching, or swelling, not primarily a headache.
  • C. While anxiety can cause headaches, a headache specifically after nitroglycerin administration is more likely a direct pharmacological effect.
  • D. Nitroglycerin's primary action is vasodilation, which lowers blood pressure, so a sudden increase in BP is highly unlikely after administration.

Nitroglycerin Side Effects

Common and expected adverse reactions that can occur following the administration of nitroglycerin due to its pharmacological actions.

  • Headache (most common, due to cerebral vasodilation).
  • Hypotension (due to systemic vasodilation).
  • Flushing.
  • Dizziness/lightheadedness.

Memory trick: Nitro's side effects: head pounds, BP drops, face flushes.

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