Which nitroglycerin sublingual dosage form is listed?

• A. Sublingual tablet 0.4 mg
• B. Oral tablet 0.4 mg
• C. Intramuscular injection 0.4 mg
• D. Inhalation aerosol 0.4 mg

Answer: (A)

Nitroglycerin is given sublingually because this route provides rapid absorption directly into the bloodstream, bypassing the liver (no first-pass metabolism) for a quick onset of action. The 0.4 mg sublingual tablet is the standard potency used in EMS and is designed to dissolve quickly under the tongue, delivering relief from anginal pain promptly. Other forms—an oral tablet—are ruined by first-pass metabolism and have slower, unpredictable effects; an intramuscular injection isn’t a typical or reliable route for nitroglycerin; and an inhalation aerosol isn’t a standard nitroglycerin form in EMS practice. Therefore, the sublingual tablet at 0.4 mg is the correct listed dosage form.