A patient with chest pain who recently used erectile dysfunction medication should not receive nitroglycerin due to what risk?

• A. Severe hypotension due to drug interaction.
• B. Severe hypertension due to rebound.
• C. Nausea.
• D. Increased heart rate.

Answer: (A)

When nitroglycerin is given to someone who has recently taken erectile dysfunction meds, the main risk is a dangerous drop in blood pressure. Nitroglycerin causes vasodilation, mainly reducing preload by dilating veins. Erectile dysfunction drugs (PDE5 inhibitors) boost levels of cGMP, leading to widespread vascular smooth muscle relaxation. Together, these effects can produce a marked and potentially life-threatening decrease in systemic blood pressure, with dizziness, fainting, and poor perfusion.

That’s why this combination is contraindicated in chest-pain patients who have recently used ED meds. The other options—nausea, rebound hypertension, or a reflex increase in heart rate—do not represent the primary danger here.