Nitroprusside Flashcards

Nitroprusside Overview

• Class: Vasodilator, used primarily to lower blood pressure quickly.
• Trade Name: Known commercially as Nipride.

Therapeutic Uses

• Indicated for hypertensive crises, allowing for a rapid decrease in systemic vascular resistance.
• Aims to improve cardiac performance and reduce arterial blood pressure during emergencies.

Side Effects

• Common reactions include dizziness, headache, nausea, abdominal pain, sweating, palpitations, weakness, and vomiting.

Life-threatening and Other Adverse Reactions

• Life-threatening conditions include severe hypotension, loss of consciousness, and profound cardiovascular depression.
• Other serious concerns comprise thiocyanate toxicity, presenting as hypotension, tinnitus, dyspnea, blurred vision, and metabolic acidosis.

Precautions

• True statement: Nitroprusside must not be mixed with any drug in a syringe or solution.
• Administered solely through IV route.

Dosage Information

• Typical dosage range is 5 mcg/kg/min, with a maximum allowance of 10 mcg/kg/min.

Light Sensitivity

• Nitroprusside is rapidly inactivated by light; IV bottles or bags should be wrapped in aluminum foil or opaque material to prevent degradation.

Solution Degradation

• A faint brown tint is usual; however, a blue or brown discoloration indicates degradation and the need for disposal.

Risk of Toxicity

• If infused at the maximum dose of 10 mcg/kg/min for over 10 minutes, patients are at risk for toxicity due to elevated serum thiocyanate or cyanide levels.
• Monitoring of serum thiocyanate levels is essential every 24 to 72 hours for those on prolonged infusions exceeding 2 mcg/kg/min.

Transitioning Therapy

• Oral antihypertensive agents should be initiated as soon as possible to allow for a gradual tapering off of nitroprusside therapy.