New York State Emergency Medical Technician (EMT) Practice Exam

If a patient with chest discomfort takes medication for erectile dysfunction, what should you recall before administering nitroglycerin?

1. It causes lower blood pressure when combined with nitroglycerin

2. It can enhance the effects of nitroglycerin

3. It can cause hypertension if given with nitroglycerin

4. It's safe to administer without any concern

The correct answer is: It can cause hypertension if given with nitroglycerin

When considering the administration of nitroglycerin to a patient who has taken medication for erectile dysfunction, it is crucial to understand the interactions between these drugs. Medications for erectile dysfunction, particularly those in the class of phosphodiesterase type 5 (PDE5) inhibitors like sildenafil (Viagra), can significantly lower blood pressure when taken in combination with nitroglycerin. Nitroglycerin is typically used to relieve chest pain (angina) by dilating blood vessels, which also results in a drop in blood pressure. If nitroglycerin is administered after the use of erectile dysfunction medication, the combined effect can lead to profound hypotension (low blood pressure), which can be dangerous and lead to serious complications, including fainting, shock, or even cardiovascular collapse. Therefore, it's vital for EMS providers to assess a patient’s medication history closely and ensure that there is sufficient time elapsed since the last dose of erectile dysfunction medication before administering nitroglycerin. The response acknowledges the importance of safety in drug interactions, especially in emergency situations.