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If the patient complains of chest pain, chest pressure or chest discomfort, administer the patient’s NTG; 1 tablet or spray IF the blood pressure is greater than 100mmHg systolic. Blood pressure must remain higher than 100 mmHg systolic for the 2nd and 3rd dose to be administered so only administer as applicable.
If a patient has taken their nitroglycerin prior to your arrival, without pain relief and you have determined that the pharmacologic potency of that nitroglycerin was normal (based upon standard side effects of the med, e.g., headache/tingling sensation) you may consider that a dose; however, you may want to contact Medical Control for other treatment options.
PD-5 “The ‘Fils’”
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For patients, both male and female, who have, taken any medications classified in the phosphodiesterase-type-5 inhibitor category within the last 48 hours, nitrates should not be administered unless medical control has been contacted and has provided the EMT (B/I/P) with a medical control order to administer nitrates. | 
