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Nitropress (Sodium Nitroprusside) - Summary

 
 



NITROPRESS® (Sodium Nitroprusside Injection) is not suitable for direct injection. The solution must be further diluted in sterile 5% dextrose injection before infusion.

NITROPRESS can cause precipitous decreases in blood pressure (see DOSAGE AND ADMINISTRATION ). In patients not properly monitored, these decreases can lead to irreversible ischemic injuries or death. Sodium nitroprusside should be used only when available equipment and personnel allow blood pressure to be continuously monitored.

Except when used briefly or at low (< 2 mcg/kg/min) infusion rates, sodium nitroprusside gives rise to important quantities of cyanide ion, which can reach toxic, potentially lethal levels (see WARNINGS ). The usual dose rate is 0.5-10 mcg/kg/min, but infusion at the maximum dose rate should never last more than 10 minutes. If blood pressure has not been adequately controlled after 10 minutes of infusion at the maximum rate, administration of sodium nitroprusside should be terminated immediately.

Although acid-base balance and venous oxygen concentration should be monitored and may indicate cyanide toxicity, these laboratory tests provide imperfect guidance.

 

NITROPRESS SUMMARY

Sodium nitroprusside is disodium pentacyanonitrosylferrate(2-) dihydrate, a hypotensive agent.

Sodium nitroprusside is indicated for the immediate reduction of blood pressure of adult and pediatric patients in hypertensive crises. Concomitant longer-acting antihypertensive medication should be administered so that the duration of treatment with sodium nitroprusside can be minimized.

Sodium nitroprusside is also indicated for producing controlled hypotension in order to reduce bleeding during surgery.

Sodium nitroprusside is also indicated for the treatment of acute congestive heart failure. 


See all Nitropress indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Nitropress (Nitroprusside Anion)

Low Blood Pressure (Hypotension) Symptoms and Treatments
Source: MedicineNet Abdominal Aortic Aneurysm Specialty [2017.09.28]
Title: Low Blood Pressure (Hypotension) Symptoms and Treatments
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 9/28/2017 12:00:00 AM

Low Blood Pressure (Hypotension)
Source: MedicineNet Cholera Specialty [2017.05.05]
Title: Low Blood Pressure (Hypotension)
Category: Symptoms and Signs
Created: 4/29/2014 12:00:00 AM
Last Editorial Review: 5/5/2017 12:00:00 AM

Orthostatic Hypotension
Source: MedicineNet Addison Disease Specialty [2017.01.13]
Title: Orthostatic Hypotension
Category: Diseases and Conditions
Created: 6/11/2009 12:00:00 AM
Last Editorial Review: 1/13/2017 12:00:00 AM

Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
Source: MedicineNet Tilt-table Test Specialty [2016.07.28]
Title: Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
Category: Slideshows
Created: 7/29/2008 12:00:00 AM
Last Editorial Review: 7/28/2016 12:00:00 AM

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Published Studies Related to Nitropress (Nitroprusside Anion)

Efficacy and safety of oral propranolol premedication to reduce reflex tachycardia during hypotensive anesthesia with sodium nitroprusside in orthognathic surgery: a double-blind randomized clinical trial. [2010.01]
PURPOSE: The present study sought to determine whether premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside could reduce reflex tachycardia, the amount of sodium nitroprusside used, and blood loss during hypotensive anesthesia for orthognathic surgery... CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside is safe and effective to reduce reflex tachycardia and the amount of sodium nitroprusside used.

Efficacy and safety of oral propranolol premedication to reduce reflex tachycardia during hypotensive anesthesia with sodium nitroprusside in orthognathic surgery: a double-blind randomized clinical trial. [2010]
loss during hypotensive anesthesia for orthognathic surgery... CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive

Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction. [2009.11.20]
BACKGROUND: No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI... CONCLUSION: Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis.

Blood loss and endocrine responses in hypotensive anaesthesia with sodium nitroprusside and nitroglycerin for mandibular osteotomy. [2009.11]
The purpose of this study was to determine the differences in endocrine responses, blood loss and arterial blood gas profiles between patients subjected to hypotensive anaesthesia or normotensive anaesthesia and those between patients given sodium nitroprusside (SNP) or nitroglycerin (NTG) as the hypotensive agent...

Randomized evaluation of intracoronary nitroprusside vs. adenosine after thrombus aspiration during primary percutaneous coronary intervention for the prevention of no-reflow in acute myocardial infarction: the REOPEN-AMI study protocol. [2009.07]
CONCLUSIONS: REOPEN-AMI will provide important data on the efficacy and safety of intracoronary nitroprusside and adenosine as an adjunctive treatment to percutaneous coronary intervention after thrombus aspiration for patients with acute myocardial infarction.

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Clinical Trials Related to Nitropress (Nitroprusside Anion)

Safety Study of Nebulized Sodium Nitroprusside in Adult Acute Lung Injury [Recruiting]
Acute lung injury (ALI) is caused by a wide variety of conditions, but always characterized by hypoxia and non-cardiogenic pulmonary edema. Current treatment of ALI is supportive and treatment of the underlying cause. New therapies to treat severe ALI have not been shown to improve survival, and are limited by financial and logistical resources. The investigators propose to investigate the role of inhaled sodium nitroprusside (iSNP) in ALI. Sodium nitroprusside (SNP) is a vasodilator. When inhaled, SNP may travel to areas of the lung participating in gas exchange, and cause the blood vessels surrounding these areas to enlarge. This may result in an increase of blood vessels to these areas of the lung, and improve oxygenation. Currently, iSNP has not been studied in the adult population. Therefore, this study is intended to find the safety profile of varying doses of iSNP.

Sodium Nitroprusside for Blood Pressure Reduction in the ICU (SNP2) [Completed]
Nitroprusside is used commonly in the Intensive Care Unit for long periods of time in order to reduce blood pressure. It is not known if the body compensates over time to the blood pressure lowering, and if when the nitroprusside is stopped the blood pressure goes up at a faster rate and is higher than it was at the start of the treatment. This study will answer these questions.

Dose-Response Study of Sodium Nitroprusside in Children Requiring Controlled Hypotension in the Operating Room [Completed]
Sodium nitroprusside (SNP) has been approved for control of blood pressure in adults, yet there are no controlled studies in children. The purpose of this study is to determine the efficacy and safety of sodium nitroprusside in children who will be having surgery, and who require blood pressure lowering in order to decrease the amount of blood loss during their surgery.

The Effect of Nitroprusside on Intrauterine Device (IUD) Insertion [Completed]
Increasing accessibility of long-acting reversible contraceptive methods, like intrauterine devices (IUDs), is an important strategy to reduce the risk of unintended pregnancy. Unfortunately, fear of IUD insertion in women who have not had children is common among health care providers and women alike, and this limits IUD use. To increase acceptance of this highly effective contraceptive, there is need to investigate novel, low cost, easily applied and accessible techniques to improve the insertion experience. This is a pilot study to evaluate the efficacy and tolerability of nitroprusside gel applied intracervically as an intervention to improve the IUD insertion experience for both patient and provider.

Remifentanil and Nitroprusside for Controlled Hypotension [Completed]

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Page last updated: 2017-09-28

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