NITROPRUSSIDE
Standard Prescription
nitroprusside__mcg/kg/min continuous IV infusion
Dosages
Antihypertensive/Afterload reduction in CHF:
Continuous IV Infusion:
Initial: 0.25-0.3 mcg/kg/min.
Titrate upward every few minutes to desired effect.
Usual dose is 3 mcg/kg/min.
Maximum dose is 10 mcg/kg/min.
Doses more than 4 mcg/kg/min. are rarely required.
Continuous IV Infusion:
Initial: 0.25-0.3 mcg/kg/min.
Titrate upward every few minutes to desired effect.
Usual dose is 3 mcg/kg/min.
Maximum dose is 10 mcg/kg/min.
Doses more than 4 mcg/kg/min. are rarely required.
Onset of action: 2 minutes
Duration: 1 - 10 minutesMechanism of Action
Vasodilator of arteriolar and venous vascular systems
Forms Supplied
injection: 25 mg/mL
Standard concentrations for Critical Care:
100 mcg/mL , 200 mcg/mL, 2000 mcg/mL, 5000 mcg/mL Comments
To be administered by infusion control devices only in Critical Care areas where facilities are available for continuous hemodynamic monitoring.
May cause precipitous hypotension in volume depleted patients. Be prepared to restore intravascular volume.
Large doses may cause cyanide toxicity (cyanomethemoglobin, neurological toxic, and metabolic acidosis); antidote: amyl nitrate; sodium nitrite, sodium thiosulfate (cyanide antidote kit).
Monitor thiocyanate and cyanide levels if used in high doses (> 2 mcg/kg/min.or total amount >500 mg/kg) for longer than 2 days. In patients with renal impairment on lower doses, check thiocyanate and cyanide levels after 2 days. Keep thiocyanate levels < 0.8 mmol/L. Thiocyanate is excreted by kidney and half-life is 3-7 days.
Protect from light.
May cause precipitous hypotension in volume depleted patients. Be prepared to restore intravascular volume.
Large doses may cause cyanide toxicity (cyanomethemoglobin, neurological toxic, and metabolic acidosis); antidote: amyl nitrate; sodium nitrite, sodium thiosulfate (cyanide antidote kit).
Monitor thiocyanate and cyanide levels if used in high doses (> 2 mcg/kg/min.or total amount >500 mg/kg) for longer than 2 days. In patients with renal impairment on lower doses, check thiocyanate and cyanide levels after 2 days. Keep thiocyanate levels < 0.8 mmol/L. Thiocyanate is excreted by kidney and half-life is 3-7 days.
Protect from light.
References
32, 44, 112
Last Edited
2019-07-15 01:00:17