Sodium Nitroprusside

Drug #665

Sodium Nitroprusside is a rapid acting antihypertensive agent. Sodium Nitroprusside is a complex of iron, cyanide group and a nitroso moiety. Chemically Sodium Nitroprusside is disodium pentacyanonotrosylferrate (2-) dihydrate. Sodium Nitroprusside is a powerful vasodilator acts by direct dilatation of blood vessels. Given parentrally for severe and acute hypertensive emergencies or for control of blood pressure during surgical procedures. Duration of action is short as metabolized to cyanide and then thiocyanate. Excessive dosage may lead to cyanide poisoning.

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Primary Characteristics

It is of Synthetic origin and belongs to Sodium Nitrosylcyanoferrate.

It belongs to EDRF (NO) agonist pharmacological group on the basis of mechanism of action and also classified in Vasodilators pharmacological group. It is also classified under Antianginal Agents .

Molecular Weight: 298 · Solubility in Water: 1 in 2.5 · Solubility in Alcohol: poor · Non-proprietary name: Sodium Nitroprusside.

Molecular structure of Sodium Nitroprusside

Pharmacokinetics

Elimination: renal excretion is extensive.

Indications

Sodium Nitroprusside is primarily indicated in conditions like Analgesia especially during short operative procedure, Congestive heart failure, Heart failure, Hypertension, Hypertensive crisis, Hypertensive emergencies, Hypotensive anaesthesia, Maintenance of bp at 30-40% lower than ptetreatment diastolic BP, Myocardial infarction, Prophylaxis of NSAID-induced duodenal ulcer, Severe or recurrent duodenal and gastric ulcertion.

Sodium Nitroprusside is also indicated for secondary conditions like Arteriovenous shunt, Pre-eclampsia.

Contraindications

Sodium Nitroprusside is contraindicated in conditions like Tobacco amblyopia, Arteriovenous shunt, Coarctation of aorta, Vitamin B12 deficiency, Leber's optic atrophy.

Dosage

Sodium Nitroprusside's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
210 ug/min	210 ug/min	—	IV Inf	As Required
Paediatric Dosage (20kg)
0.85 ug/kg.min	0.85 ug/kg.min	—	IV Infusion	As required
Neonatal Dosage (3kg)
0 – 0	—	—		Not recommended in this age group

Drug Interactions

Unknown4 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Sodium Nitroprusside in overdosage may give rise to further complications which include Hypothyroidism .

Sodium Nitroprusside produces potentially life-threatening effects which include Increased anaerobic metabolism. Careful monitoring is needed with proper medical management.

Sodium Nitroprusside is known to cause more or less tolerable side effects which are usually transient. These include Abdominal discomfort, Diaphoresis, Dizziness, Headache, Muscle twitching, Nausea, Palpitation, Restlessness, Retrosternal discomfort.

Warnings / Precautions

Sodium nitroprusside should be used with caution and in low doses (initially) in elderly patients because they may be more sensitive to hypotensive effects. It should be used with caution in patients with severe renal (kidney) impairment, liver insufficiency, impaired cerebral circulation, tobacco amblyopia or in vitamin B deficiency.

Interference in Pathology

Sodium Nitroprusside may interfere in the diagnosis of Increased serum cyanide concentrations, Increased methemoglobin blood concentrations.

Available Brands

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Single Ingredient

Cream

2 %w/w

Inj

50 mg

Storage Conditions

Sodium Nitroprusside should be stored Inj (reconsitututed soln).

Drug Classification

1.12.3.7 — Direct vasodilators

Manufacturers

Manufacturers of Sodium Nitroprusside in Pakistan:

Ambrosia Graton