Viagra/Nitro Situation?

[ebemt]

I just got into a debate w/ several members of my squad about this issue. As an EMT-B are we allowed to administer nitro to a patient using Viagra? What exactly are the harmful effects of doing this?

[noahmedic]

Short answer, NO! I would suggest you google for the answer, and read exactly why. I will help it stick in your head more if you look it up and read it.

[MedicMal]

What do your medical directives say? I know in Ontario we're not allowed to give Nitro if the pt has had viagara within the past 48 hours (some services say 24 hours). The 2 drugs combined can be very harmful. Without getting into lots of detail, basically both drugs are vasodilators and when combined can make a pt very hypotensive.

MedicMal

[Dsmittty911]

Here I believe it's 48 hours. It causes very serious hypovolemic shock. It's like someone opened a spigot (or dilated all the blood vessels) and let the blood out. No elasticity in the veins means no bp and last time i checked that's a very bad bad thing. Causes a very serious case of DRT. (Dust you may recognize this one from your PHTLS class here. One of Dave's favorite sayings) Dead Right There. It's irreversible in prehospital setting. In other words you just killed your pt.

[bandaidpatrol]

The question should be, how long after taking the medication, is it safe to administer a nitrate.

Another question is; Is the patient just prescribed the medication, or when was the last time he took it.

It's not a medication one would take every day.. And no, I don't use it. Knock on wood, I don't require any medications.

[nsmedic393]

There should be no debate at all about this. It is widely known that use of viagra within at least 24 hours is a contraindication for giving NTG. Both drugs act in synergy to produce vasodilatory effects that neither could produce alone. When you throw into the fix a heart that is already being deprived of blood (ischemic chest pain) then you are getting into trouble.

[AZCEP]

It's not a medication one would take every day.. And no, I don't use it. Knock on wood, I don't require any medications.

You said "wood"

Viagra/Levitra/Cialis all work the same way, with different life spans.

I will agree that if you must seek answers, having them given to you is not a good way to remember the responses. I suggest you try rxlist.com for the knowledge you seek.

[Dustdevil]

And, as always, minus five for posting an ALS topic in the BLS forum.

[Ridryder 911]

For those that want to really know how Viagra works.. it is a lot more complicated than was discussed. Here is a free site on the patho-pharmokenitics written for nurse.

http://www.rnceus.com/course_frame.asp?exa...irectory=viagra

R/R 911

[MedicMal]

And, as always, minus five for posting an ALS topic in the BLS forum.

Well actually, PCPs (In Ontario) which are considered BLS can administer Nitro. :roll:

MedicMal