Nitroprusside/Nipride


- See: 
- After-Load 
- Toxicity 
- Discussion:

- direct acting arterial & venous dilator is treatment of choice for HTN crises
- if HTN remains, despite max dosing then use Chlorpromazine
- consider Hydralazine when weaning from drip; 
- w/ Aortic dissection, Nitroprusside useful, but must be used with Beta blocker-
-reduces Intra Vent Press and Shearing Force; 
- Acute MI; CHF; 
- Adult Dosing: 
- 0.5 - 10 ug/kg/min IV infusion (0.5 ug/kg/min = 10 ml/hr) titrated to effect;

- avg dose of 1-3ug/kg/min will usually lower diastolic pressure by 30-40%; 
- note: w/ d/c of IV, effects end in 5 min; 
- infusions must be protected from light; 
- Peds: 0.5-10 ug/kg/min IV infusion; average of 1.0-3.0 ug/kg/min; 
- Supplied as 5 ml vials containing 50 mg Na Nitroprusside to be reconstituted with sterile 5% dextrose in H20; (eg. 50mg / 250ml of D5W) 


Use of vitamin B12 in the treatment and prevention of nitroprusside-induced cyanide toxicity.

 




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, December 16, 2011 4:12 pm