Nitroprusside

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Trade Name

Nipride

Mechanism

Sodium Nitroprusside contains five cyanide groups and a it nitrosyl group surrounding by a ferrous ion center. Its breakdown once entering the body releases cyanide and nitric oxide. The release of nitric oxide is what is thought to give Sodium Nitroprusside its vasodilating effect. The cyanide groups are metabolized in the liver and excreted in the urine.

Dose

  • 3 mcg/kg/min IV - titrate to effect
  • Dose should not exceed 10 mcg/kg/minute

Indications

Used during Cardiopulmonary bypass to dilate arterial vessels.

Site of action

Arterial and venous smooth muscle

Adverse Effects

Excessive hypotension. Cyanide poisoning.

Contraindications

Renal disease. Hepatic disease. Pregnancy

References

https://journals.lww.com/anesthesia-analgesia/Fulltext/1995/07000/Sodium_Nitroprusside__Twenty_Years_and_Counting.31.aspx

The Manual of Clinical Perfusion page 228

https://www.ncbi.nlm.nih.gov/books/NBK557487/