a. Action and Uses. Amyl nitrite has the action discussed above. In addition
to its therapeutic use in the treatment of angina pectoris, it may be used to combat the
effects of cyanide gas poisoning.
b. Administration. This drug is administered by inhalation. The pearl (ampule
covered with a cloth mesh) is crushed in a handkerchief or in paper tissue and placed
over the client's nose. The client inhales the fumes two or three times. When he has
inhaled about 0.3 ml of the drug (average dose), there is onset of action within 20
seconds, which lasts for 7 to 10 minutes. When administered to a victim of cyanide gas
poisoning, two pearls should be crushed and placed inside his gas mask. The original
dose of two pearls is repeated three times (eight ampules).
c. Caution. Amyl nitrite should not be used in the presence of flame, because
it is a very flammable agent.
d. How Supplied. The drug is supplied in 0.33-ml pearls, which should be kept
refrigerated but protected from freezing. The drug is subject to deterioration after 24
4-14. NITROGLYCERIN TABLETS
a. Action and Uses. Nitroglycerin tablets (glyceryl trinitrate tablets) are used
chiefly to give relief from the pain associated with angina pectoris attacks. This drug
may also be used as an aid in the diagnosis of migraine.
b. Administration. The tablets are administered sublingually (placed under the
tongue and allowed to dissolve) in a dose of 0.3 to 0.6 mg. The onset of action of the
drug commonly takes about 30 seconds, and its effects last for 20 to 30 minutes.
c. How Supplied. Nitroglycerin is available as soluble tablets, 0.3 mg, 0.4 mg,
and 0.6-mg in strength.
Section V. FLUID AND ELECTROLYTE THERAPY
4-15. FLUID VOLUME REPLACEMENT
a. Discussion. The essential need in hypovolemic (oligemic) shock is
restoration of the depleted fluid volume. When fluid volume is restored, the
improvement in the circulation permits the most effective use of the blood that the client
has not lost.
b. Choice of Replacement Fluid. The choice of replacement fluid is based on
the type of fluid lost (whether whole blood, plasma, or water and electrolytes), the
availability of specific fluids, and laboratory facilities. Whole blood is often the most