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Sodium Nitroprusside

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Updated May 27, 2014

Sodium nitroprusside is a powerful anti-hypertension medicine that is only used in certain situations. Patients with hypertensive emergency, or those who have very high blood pressure after heart or blood vessel surgery, may be treated with sodium nitroprusside. Sodium nitroprusside cannot be taken as a pill; it must be given intravenously. For this reason, its use is restricted to the hospital setting. Along with its blood pressure-reducing actions, sodium nitroprusside also alters the pattern of blood flow through the vessels that feed the heart, making it useful in the treatment of patients with heart problems.

How Sodium Nitroprusside Works:

Like all nitrates, sodium nitroprusside works by relaxing blood vessels. Once in the body, sodium nitroprusside is quickly broken down into nitric oxide, a powerful vasodilator. This nitric oxide causes the muscles surrounding blood vessels to relax, allowing the blood vessels themselves to expand. As the blood vessels expand, blood pressure drops. The breakdown of sodium nitroprusside to nitric oxide happens very quickly, so there is virtually no delay between administration of the drug and blood pressure reduction.

Other Drugs Like Sodium Nitroprusside:

Several nitrate based drugs are used for the treatment of high blood pressure and heart problems. Two common nitrates are:

All of the nitrate drugs can be used to treat heart problems, and some, like nitroglycerin, are used almost exclusively for that purpose.

Sodium Nitroprusside Side Effects:

The most serious potential side effect of sodium nitroprusside is cyanide poisoning. The conversion of sodium nitroprusside to nitric oxide produces cyanide as a byproduct. In small amounts, this cyanide is handled by liver, which changes it into a less toxic chemical that is quickly excreted in the urine. In cases of long-term use, or if too much is used at one time, the cyanide can overwhelm the the liver and lead to cyanide poisoning. Warning signs include:

  • Confusion
  • Nausea
  • Fatigue
The primary treatment is simply to stop the sodium nitroprusside and give supportive care until the body eliminates the cyanide.

Notes:

Only you and your doctor can decide on a proper medication for treatment of high blood pressure. Be sure to notify your doctor if you are pregnant or breastfeeding, and to supply the names of any other medicines and/or supplements you are taking. Remember to include over-the-counter medicines, like aspirin or Advil (ibuprofen), and herbal/natural supplements.

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  5. Sodium Nitroprusside for Hypertension Treatment

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