What is the nitroglycerin dosing in the STEMI protocol?

• A. 0.4 mg SL; may repeat q5min x2
• B. 0.8 mg SL; may repeat q5min x2
• C. 0.4 mg IV bolus
• D. 0.4 mg SL every 2 minutes for 5 doses

Answer: (A)

Nitro dosing in STEMI uses a small, rapid-acting sublingual dose to quickly relieve chest pain and ischemia. The standard plan is 0.4 mg taken under the tongue, with repeats every 5 minutes up to two additional doses if the patient’s blood pressure remains adequate and symptoms persist. This means a total of three doses can be given (0.4 mg initially, then up to two repeats). Higher amounts, like 0.8 mg, or using an IV bolus, or giving a dose every 2 minutes for multiple doses, aren’t part of this STEMI protocol. Remember to reassess blood pressure and symptoms after each dose and hold nitro if hypotension or other contraindications are present.