Drug Index

Nitroprusside

 
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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.


07/17/2019 20:49:09 Nitroprusside
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