Drug Index

Nitroprusside

 
print
Synonyms :

Nitroferricyanide, Sodium Nitroprusside

Mechanism :

Peripheral vasodilation by direct action on venous and arteriolar smooth muscle thus reducing peripheral resistance; will increase cardiac output by decreasing afterload, reduces aortal and left ventricular impedance.


Indication :

• Management of hypertensive crisis

• CHF

• Controlled hypotension during surgery

• Angina


Contraindications :

Hypersensitivity, Decreased cerebral perfusion, Arteriovenous shunt or coarctation of aorta.


Dosing :

IV continuous infusion: Start 0.3-0.5 mcg/kg/min titrate upwards (usual dose: 3 mcg/kg/min, maximum dose 8-10 mcg/kg/min).


Adverse Effect :

Excessive hypotension, palpitations, substernal distress, tachyarrhythmia, restlessness, disorientation, psychosis, headache, elevated intracranial pressure, thyroid suppression, metabolic acidosis, nausea, vomiting, bowel obstruction, thiocyanate toxicity, neuromuscular & skeletal weakness, muscle twitch, diaphoresis, cyanide toxicity, rash, injection site irritation, oliguria, azotemia.


Interaction :

Alteplase: IV nitroglycerin may decrease the effect of alteplase.
Avanafil: Additive vasodilation. Concomitant therapy is contraindicated.
Azilsartan medoxomil: Pharmacodynamic synergist- increases effects.
Dihydroergotamine: Possible antagonism of action.
Ergonovine: Possible antagonism of action.
Ergotamine: Possible antagonism of action.
Methylergometrine: Possible antagonism of action.
Methysergide: Possible antagonism of action.
Sildenafil: Possible significant hypotension with this combination.
Tadalafil: The vasodilatory effects of Nitroglycerin may be increased by Tadalafil. Severe hypotension may occur. Concomitant therapy is contraindicated.
Treprostinil: Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.
Udenafil: The vasodilatory effects of Nitroglycerin may be increased by Udenafil. Severe hypotension may occur. Concomitant therapy is contraindicated.
Vardenafil: The vasodilatory effects of Nitroglycerin may be increased by Vardenafil. Severe hypotension may occur. Concomitant therapy is contraindicated.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function. Avoid prolonged use
<10Dose as in normal renal function. Avoid prolonged use

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/min
HDF/High fluxDialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Nitroprusside is metabolized in the liver so use with caution. Since cyanide is metabolized by hepatic enzymes, it may accumulate in patients with severe hepatic impairment.
05/21/2020 21:24:01 Nitroprusside
ask a doctor
Ask a Doctor
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0