What is an important instruction for a patient receiving a nitroglycerin patch?

Having a nitrate-free interval of 10 to 12 hours daily is crucial for patients using a nitroglycerin patch to prevent the development of tolerance to the medication. Prolonged exposure to nitrates can lead the body to adapt, diminishing the drug's effectiveness over time. This is particularly important with patches, as they provide a continuous release of the medication.

To maintain the effectiveness of nitroglycerin, it is recommended that patients remove the patch for this designated period. This allows the body's pharmacological response to recover and ensures that the nitroglycerin will continue to produce the desired effects during subsequent use.

In contrast, applying a patch at the onset of angina symptoms is not ideal, as patches are designed for sustained treatment rather than immediate relief. Removing a patch immediately after 24 hours and applying a new one without a gap does not incorporate this necessary interval and could lead to tolerance. Additionally, using sublingual nitroglycerin while on a patch does not inherently present safety issues, but the instructions regarding usage need careful consideration based on individual patient plans and health care provider guidance.