Which of the following represents a situation in which nitroglycerin should not be used?

Using nitroglycerin has specific contraindications, primarily due to safety concerns with certain medications and patient conditions. One of the significant contraindications for nitroglycerin administration is the recent use of phosphodiesterase inhibitors, which are commonly found in sexual enhancement drugs such as Viagra (sildenafil) or Cialis (tadalafil). These medications can lead to a severe drop in blood pressure when combined with nitroglycerin because both act as vasodilators. Therefore, if a patient has taken these types of drugs, nitroglycerin should not be administered to avoid potentially life-threatening hypotension.

In other scenarios, such as a patient experiencing chest pain, having a systolic blood pressure of 120, or experiencing anxiety, nitroglycerin may still be indicated, assuming no other contraindications are present. For example, a systolic blood pressure of 120 is generally considered adequate for administering nitroglycerin, provided the patient does not exhibit other contraindicating factors or symptoms. Similarly, anxiety does not prevent the use of nitroglycerin if the underlying issue, such as angina or myocardial infarction, is present and no contraindications such as recent use of certain medications exist.