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2250409 
Technical Report 
Effect of sublingual nitroglycerin in emergency treatment of severe pulmonary edema 
Bussman, WD; Schupp, D 
1978 
IPA/79/317058 
J 
REF 19 
931-936 
eng 
IPA COPYRIGHT: ASHP Twenty-two patients were studied to document the effects of sublingual nitroglycerin (I) as a single drug in the emergency treatment of pulmonary edema. Hemodynamic studies were performed in 7 patients (Group A). In 15 patients (Group B), the clinical course was observed and documented. Group B patients received one to 6 doses of I, 0.8 to 2.4 mg sublingually at intervals of 5 to 10 min. Three patients also received IV doses of I. In group A, left ventricular filling pressure decreased and cardiac output increased. Othopnea and pulmonary rales disappeared rapidly. In group B, clinical improvement was noted in 7 patients 5 min after administration of I. After 15 to 20 min, pulmonary rales disappeared or decreased in 11 and dyspnea decreased significantly. Only one patient with terminal pulmonary edema remained refractory to therapy. Sublingual I had beneficial effects in the emergency treatment of classic pulmonary edema. Elevated left ventricular filling pressure decreased and cardiac output increased within 5 min. These hemodynamic changes produced immediate clinical improvement.