Sodium Nitroprusside

Sodium Nitroprusside is a rapid acting antihypertensive agent. Sodium Nitroprusside is a complex of iron, cyanide group and a nitroso moiety. Chemically Sodium Nitroprusside is disodium pentacyanonotrosylferrate (2-) dihydrate. Sodium Nitroprusside is a powerful vasodilator acts by direct dilatation of blood vessels. Given parentrally for severe and acute hypertensive emergencies or for control of blood pressure during surgical procedures. Duration of action is short as metabolized to cyanide and then thiocyanate. Excessive dosage may lead to cyanide poisoning.

Brands
NIPRIDE NIZOZOLE
Adult Dose
Dose: 20 to 400 ug/min
Single Dose: 210 (210)
Frequency: As recommended.
Route: IV Inf
Instructions: As Required
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose: 0.3 to 1.4 ug/kg.min
Single Dose: 0.85 (0.85)
Frequency: As recommended.
Route: IV Infusion
Instructions: As required
Characteristics
. It is of Synthetic origin and belongs to Sodium Nitrosylcyanoferrate. It belongs to EDRF (NO) agonist pharmacological group on the basis of mechanism of action and also classified in Antianginal Agents and Vasodilators pharmacological group.The Molecular Weight of Sodium Nitroprusside is 298.00.
Contraindications
'Sodium Nitroprusside is contraindicated in conditions like Tobacco amblyopia,Arteriovenous shunt,Coarctation of aorta,Vitamin B12 deficiency,Leber''s optic atrophy.'
Effects
The severe or irreversible adverse effects of Sodium Nitroprusside, which give rise to further complications include Hypothyroidism.Sodium Nitroprusside produces potentially life-threatening effects which include Increased anaerobic metabolism. which are responsible for the discontinuation of Sodium Nitroprusside therapy.The symptomatic adverse reactions produced by Sodium Nitroprusside are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Restlessness, Palpitation, Diaphoresis, Muscle twitching, Retrosternal discomfort, Abdominal discomfort.
Indications
Sodium Nitroprusside is primarily indicated in conditions like Analgesia especially during short operative procedure, Congestive heart failure, Heart failure, Hypertension, Hypertensive crisis, Hypertensive emergencies, Hypotensive anaesthesia, Maintenance of bp at 30-40% lower than ptetreatment diastolic BP, Myocardial infarction, Prophylaxis of NSAID-induced duodenal ulcer, Severe or recurrent duodenal and gastric ulcertion, and can also be given in adjunctive therapy as an alternative drug of choice in Arteriovenous shunt, Pre-eclampsia.
Interactions
Sodium Nitroprusside is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlteplaseDigoxinDobutamine (HCl)Dopamine (HCl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Increased serum cyanide concentrationsIncreased methemoglobin blood concentrations
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconsitututed soln) Store at room temperature. Protect from Sunlight, Moisture and Heat. Use within 24 hrs if kept at room temperature.
Warnings
Sodium nitroprusside should be used with caution and in low doses (initially) in elderly patients because they may be more sensitive to hypotensive effects. It should be used with caution in patients with severe renal (kidney) impairment, liver insufficiency, impaired cerebral circulation, tobacco amblyopia or in vitamin B deficiency.
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