Nitroprusside Therapy

Sodium nitroprusside contains 40 percent cyanide by weight. Cyanide is released by the deterioration of sodium nitroprusside in aqueous solutions, especially when exposed to bright sunlight. The rate of rise of cyanide levels in patients on a nitroprusside infusion is proportional to the infusion rate and increases at infusion rates greater than 1 to 2 ^g/kg/min.6 The onset of poisoning occurs after several days of therapy, so the emergency physician will see this problem only if called to the intensive care unit to evaluate a deteriorating patient. Cyanide poisoning should be suspected in patients receiving nitroprusside infusions who develop mental state disturbances or unexplained metabolic acidosis. In patients in whom a Swan-Ganz catheter is used for monitoring, a narrow ( A-v) O2 difference, especially in the setting of an unchanged or declining cardiac output, suggests cyanide toxicity. 6

Was this article helpful?

0 0
How To Win Your War Against Bronchitis

How To Win Your War Against Bronchitis

Sick And Tired Of Your Constant Cough? Is Your Bad Immune System Leading You To The Path Of Fever And Sore Chest? You Sure Have A Reason To Panic BronchitisThere Is Always A Way Out And, This Is It Finally Discover Some Of The Most Effective Tips That Can Curb Bronchitis, And Its Repeated Bouts Learn How To Keep The Chronic Cough, And Sore Chest Away Breathe Free, And Feel The Whiff Of Fresh Air, With No Hassles

Get My Free Ebook


Post a comment