Questions and Answers
What are the pharmacotherapeutics of nitroprusside?
Indicated in hypertensive crisis.
What are the pharmacodynamics of nitroprusside?
Directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.
What are the contraindications of nitroprusside?
Aortic coarctation or arteriovenous shunting.
What are the adverse effects of nitroprusside?
Signup and view all the answers
If there's a fast drop in blood pressure, what adverse effects could a patient experience?
Signup and view all the answers
What are some signs of cyanide toxicity?
Signup and view all the answers
What medications should you be aware of when taking nitroprusside?
Signup and view all the answers
What should you consider about a patient's life when taking nitroprusside?
Signup and view all the answers
What pregnancy category is nitroprusside?
Signup and view all the answers
How can you maximize therapeutic effects of nitroprusside?
Signup and view all the answers
How can you minimize adverse effects of nitroprusside?
Signup and view all the answers
What are some nursing implications of nitroprusside?
Signup and view all the answers
What should you educate the patient and family about nitroprusside?
Signup and view all the answers
What is the drug of choice for hypertensive crisis when blood pressure must be reduced immediately?
Signup and view all the answers
What is a black box warning associated with nitroprusside?
Signup and view all the answers
What is an unusual adverse effect to watch for with nitroprusside infusion?
Signup and view all the answers
Study Notes
Pharmacotherapeutics of Nitroprusside
- Indicated for hypertensive crises requiring immediate blood pressure reduction.
Pharmacodynamics of Nitroprusside
- Directly relaxes vascular smooth muscle, resulting in dilation of peripheral arteries and veins.
- Exhibits rapid onset with a short half-life.
Contraindications of Nitroprusside
- Contraindicated in aortic coarctation and arteriovenous shunting.
- Requires dilution after reconstitution.
- Risk of severe BP drop, leading to potential irreversible ischemic injury.
- Caution in cases of cyanide poisoning with high doses; particularly dangerous during procedures on patients with inadequate cerebral circulation.
Adverse Effects of Nitroprusside
- Commonly causes hypotension, especially from rapid infusion.
- Serious risks include severe hypotension and cyanide toxicity.
Symptoms of Rapid BP Drop
- May present with abdominal pain, apprehension, diaphoresis, dizziness, headache, nausea, restlessness, and retrosternal discomfort.
Signs of Cyanide Toxicity
- Characterized by venous hyperoxemia (bright red blood), metabolic/lactic acidosis, air hunger, confusion, and risk of death.
Drug Interactions
- Watch for interactions with erectile dysfunction medications.
Patient Considerations
- Nitroprusside induces rapid hypotensive effects across all demographics.
Pregnancy Category
- Classified as Category C, indicating potential risks in pregnancy.
Maximizing Therapeutic Effects
- Infusion rate should be titrated to lower BP without compromising organ perfusion.
- Protect the diluted drug from light by wrapping in opaque material.
Minimizing Adverse Effects
- Start nitroprusside infusion at a low rate (0.3 mcg/kg/min) and gradually increase to a max of 10 mcg/kg/min.
- Use an IV pump for regulation and maintain continuous BP monitoring throughout therapy.
Nursing Implications
- IV nitroprusside bags must be wrapped to protect from light exposure.
Patient and Family Education
- Inform patients and families that nitroprusside is administered to rapidly lower BP, with constant monitoring to prevent dangerously low levels.
- Advise vigilance for symptoms resembling a heart attack.
Clinical Use
- Nitroprusside is the drug of choice for immediate blood pressure reduction during hypertensive crises.
- Typically administered in an ICU, ER, or PACU setting.
Black Box Warning
- Not suitable for direct injection post-reconstitution; must be further diluted.
- Risk of sudden, substantial BP decreases and potential cyanide toxicity, which can be fatal.
Unusual Adverse Effects
- Monitor for signs of cyanide toxicity as an unusual adverse effect during infusion.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers the pharmacotherapeutics, pharmacodynamics, contraindications, and adverse effects of Nitroprusside. Test your knowledge on its clinical use, mechanism of action, and potential risks associated with this medication. Ideal for healthcare professionals looking to deepen their understanding of hypertension management.
