Nitroprusside: Difference between revisions
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==Contraindications== | ==Contraindications== | ||
*Pregnancy | |||
*[[ICH]] - theoretical concern for raising [[ICP]] via cerebral vasodilation, consider [[nicardipine]] instead<ref>Suri MF et al. A multicenter comparison of outcomes associated with intravenous nitroprusside and nicardipine treatment among patients with intracerebral hemorrhage. Neurocrit Care. 2009;11(1):50-5. doi: 10.1007/s12028-009-9192-1. Epub 2009 Feb 18.</ref> | |||
*Aortic coarctation | |||
*Arteriovenous shunt | |||
*Existing cyanide toxicity | |||
*High output heart failure | |||
==Indications== | ==Indications== | ||
Revision as of 23:24, 6 October 2018
Background
- Sodium nitroprusside is primarily used as a potent vasodilator.
- Works predominantly in arterioles and venules as a result of its breakdown to nitric oxide (NO).[1]
- Nitric oxide reduces both total peripheral resistance and venous return, thus decreasing both preload and afterload
- Thiocyanate level when checking for toxicity
Adult Dosing
- Start 0.5 mcg/kg/min IV, increasing 0.5 mcg/kg/min q5 min
- Usual dosage 3-4 mcg/kg/min IV
- Max dose 10 mcg/kg/min for 10 min
Pediatric Dosing
- Start 0.3 mcg/kg/min IV, max 10 mcg/kg/min for 10 min
Contraindications
- Pregnancy
- ICH - theoretical concern for raising ICP via cerebral vasodilation, consider nicardipine instead[2]
- Aortic coarctation
- Arteriovenous shunt
- Existing cyanide toxicity
- High output heart failure
Indications
Mechanism of Action
Potent arteriolar dilation from its active metabolite, nitric oxide (NO).
Adverse Drug Reactions
Kinetics
See Also
- ↑ "nitroprusside sodium (Rx) - Nipride, Nitropress, more..". Medscape Reference. WebMD. Retrieved 20 November 2013.
- ↑ Suri MF et al. A multicenter comparison of outcomes associated with intravenous nitroprusside and nicardipine treatment among patients with intracerebral hemorrhage. Neurocrit Care. 2009;11(1):50-5. doi: 10.1007/s12028-009-9192-1. Epub 2009 Feb 18.