Sublingual nitroglycerin, 0.4 mg, was prescribed for a patient. When he developed chest pain, a graduate nurse emptied the bottle of tablets into the patient's hand. He swallowed all the tablets, and his BP dropped to 80/40. He was transferred to the ICU for monitoring but wasn't permanently harmed.

Because sublingual nitroglycerin tablets may lose strength if exposed to air, heat, or moisture for long periods, they're stocked in bottles of 25 tablets rather than unit-dose packaging. In fact, nitroglycerin may be the only drug in the patient-care unit not in unit doses, so nurses may not expect more than one dose in the container.

Make sure you know the administration route for any medication you administer: Sublingual tablets shouldn't be chewed, crushed, or swallowed. If you have questions, call the pharmacy.