Sodium Nitroprusside

Sodium nitroprusside, or also known as nitroprusside, is a vasodilator that works by relaxing muscles in blood vessels to help widen. This reduces blood pressure and allow blood to flow more easily through the veins and arterti.

Indications:

To treat congestive heart failure and high blood pressure that threaten life (hypertension).

The drug is also used to maintain blood pressure remained low during the surgery / operation.

Dosage:

Initial dose: 0.3-0.5 mcg / kg / min

May be increased with the increase of 0.5 mcg / kg / min

Adjust the dose depending on the hemodynamic effect or the appearance of headache or hangover.

Usual dose: 3 mcg / kg / min

Maximum dose: 10 mcg / kg / min

Penginfusan faster than 2 mcg / kg / min cause cyanide faster than you can handle the patient.

Side Effects:

Adverse effects typically associated with the hypotensive effect or from the excessive accumulation of cyanide.

This influence can be reduced by reducing the dose infusion: Effect of GI (N / V, abdominal pain); CNS effects of fear, headache, dizziness, fatigue); Effects of CV (retrosternal discomfort, palpitations); Other effects (perspirasi, muscle spasms .)

Excessive Cyanide may cause: tachycardia, sweating, hyperventilation, arrhythmias and metabolic acidosis, methemoglobinemia can also occur.

Thiocyanate can cause: Tinnitus, miosis, hiperrefleksia, confusion, hallucinations and found the possibility of compulsive.

Special Instructions:

The balance of blood pressure (BP) and acid-base should be watched closely.

Avoid ekstravasi.

Avoid the compensator hypertension.

Use with caution or not given at all in patients with liver damage, patients with low plasma cobalamin, or Leber’s optic atrophy.

Use with caution in patients with cerebrovascular circulation is weak, the patient hypothyroidism.

If continued for more than 72 days, plasma concentrations or cyanide should be monitored.

If the use is stopped, reduce the dose gradually.