Question 1

How do you remember Nitroglycerin?

Accepted Answer

Nitroglycerin breaks down as NITRO = nitric oxide + GLYCERIN = glidin'. Break nitroglycerin into NITRO and glycerin (sounds like GLIDIN'). NITRO is nitric oxide, the molecule the drug releases. GLIDIN' reminds you it relaxes your veins, so the blood is glidin' through the roomy, dilated veins. As blood glides in and pools there, less of it returns to the heart, so preload falls.

Question 2

What class of drug is Nitroglycerin?

Accepted Answer

Nitroglycerin is a Nitrate • Venodilator • Angina.

Question 3

How is Nitroglycerin tested on the USMLE?

Accepted Answer

Nitroglycerin releases nitric oxide, which raises cGMP in vascular smooth muscle and relaxes it. It preferentially dilates veins over arteries, lowering preload. Reflex tachycardia can occur.

Question 4

A 61-year-old man with stable angina takes sublingual nitroglycerin during an episode of chest pain and gets rapid relief. At typical doses, which hemodynamic change is most responsible for reducing his myocardial oxygen demand?

Accepted Answer

A - Nitroglycerin is venodilator predominant at therapeutic doses. Dilating veins pools blood peripherally and cuts venous return, which lowers preload, ventricular wall stress, and oxygen demand. B happens only at higher doses and is not the main effect, C contributes little in fixed atherosclerotic disease, and D is wrong because reflex tachycardia actually occurs.

Nitroglycerin

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