If a patient with known angina has a GTN spray, what should you do during an episode?

• A. Help them use GTN spray under the tongue.
• B. Give them water.
• C. Administer insulin.
• D. Apply heat.

Answer: (A)

When a patient with known angina has an episode, the quick-acting nitroglycerin spray given sublingually is the immediate measure to relieve the chest pain. Absorbed under the tongue, it dilates the coronary vessels and lowers the heart’s oxygen demand, which can rapidly ease angina symptoms. So the best action is to help the patient use the spray under the tongue, making sure they place the nozzle under the tongue and avoid swallowing it right away.

If the pain persists, follow the usual protocol for repeat dosing at five-minute intervals, up to the prescribed limit, and seek help if there’s no improvement or if symptoms worsen. While waiting, keep the patient calm and seated and monitor them.

Water won’t relieve the vascular effects of GTN, insulin is not related to an angina episode, and applying heat could increase heart workload and worsen pain.