GTN Angina Dose — MFDS Part 1 MCQ

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EasyPharmacologyGTN Angina DoseMFDS Part 1

A conscious adult with known stable angina develops their usual chest pain during dental treatment. Treatment is stopped and the patient is rested in a comfortable position. Which emergency drug is most appropriate initially?

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Correct answer: E — Glyceryl trinitrate spray, 400 micrograms sublingually

Glyceryl trinitrate (GTN) spray is used for rapid relief of an acute angina attack. One metered spray delivers 400 micrograms sublingually; UK instructions permit one or two sprays. If pain persists, a second dose may be given after five minutes. Call 999 if pain remains five minutes after the second dose, worsens, or the patient becomes unwell, as this may represent acute coronary syndrome. Aspirin 300 mg is used when myocardial infarction is suspected rather than for initial relief of the patient's usual stable angina. Intramuscular adrenaline treats anaphylaxis, buccal midazolam treats a prolonged convulsive seizure, and intramuscular glucagon is an option for severe hypoglycaemia when oral glucose cannot be given.

Reference: Aspire Pharma Ltd. Glyceryl Trinitrate Spray 400 micrograms/metered dose, sublingual spray: Summary of Product Characteristics, sections 4.1–4.2. Updated 20 June 2023. https://www.medicines.org.uk/emc/product/674/smpc