How should nitroglycerin be administered to a patient with chest pain?

Administering nitroglycerin sublingually every 5 minutes, up to 3 doses, is the most acute and effective method for treating chest pain associated with angina or acute coronary syndrome. The sublingual route allows the medication to be absorbed directly into the bloodstream, leading to rapid onset of action—typically within 1 to 3 minutes. This quick response is crucial in situations where patients are experiencing chest pain, as it can alleviate symptoms promptly and help prevent further complications such as myocardial infarction.

This method is specifically designed for quick relief and is commonly recommended in practice. The guideline for administration, which allows for up to three doses, ensures that if the initial dose does not relieve the pain, subsequent doses can be given quickly in an attempt to manage the situation effectively. This practice is based on the principle that if pain persists even after multiple doses, further medical evaluation is necessary, as it may indicate a more serious cardiac event.

In contrast, other methods of administration such as intravenous or topical might be used in specific hospital settings or for different management goals but are not appropriate as first-line options for immediate chest pain relief in outpatient situations. Oral administration every 12 hours would not provide the necessary fast action that acute chest pain requires