Description of the medicine: Natrium nitroprusside (Natrium nitroprussid)

SODIUM NITROPROSSIDE (Natrium nitroprussid).

Sodium nitrosyl penta cyanoferrate.

Synonyms: Naniprus, Niprid, Nipruton, Hypoten, Nanipruss, Natrium nitroprussicum, Nipride, Niprus, Nipruton, Sodium nitroprusside.

Reddish brown crystals (or powder).

Available for injection (with the addition of a filler) in the form of a lyophilized porous mass or powder from a creamy to a rosy-colored color. Easily soluble in water.

It is a highly effective peripheral vasodilator. It expands arterioles and partially veins. With intravenous administration it has a fast, strong and relatively short-term hypotensive effect; Reduces the burden on the heart and the need for myocardium in oxygen.

Based on current data, the mechanism of action of the drug is associated with the vasodilatory action of the nitroso group (NO), which is linked through the CN groups to the iron atom.

The hypotensive effect after intravenous administration develops in the first 2 to 5 minutes, and after 5-15 minutes after the end of the injection the blood pressure returns to the initial level.

Apply sodium nitroprusside in complex therapy for acute heart failure, especially in cases that are resistant to conventional therapeutic measures. The introduction of the drug quickly reduces the signs of cardiac asthma and threatening pulmonary edema and improves the parameters of cardiac hyodynamics.

Introduce sodium nitroprusside for a short time, then switch to conventional therapy (diuretics, cardiac glycosides, etc.).

They are also used in hypertensive crises for rapid lowering of blood pressure, especially with hypertension complicated by acute heart failure, including acute myocardial infarction, hypertensive encephalopathy, cerebral bleeding, pheochromocytoma, sometimes with Raynaud's syndrome and vascular spasms caused by ergot poisoning.

The drug is administered intravenously; When administered to the hypotensive effect does not.

A solution of sodium nitroprusside is prepared immediately before use. First, dissolve the contents of one ampoule (25 or 50 mg) in 5 ml of a 5% solution of glucose, and then dilute an additional 1000; 500 or 250 ml of a 5% solution of glucose. When 50 mg of the drug is diluted in 500 ml of the solution, 1 ml contains 100 μg (diluted in 250 or 1000 ml, respectively, 200 or 50 μg).

The use of undiluted mortar is not allowed.

For infusions lasting up to 3 hours, the following doses are recommended per 1 kg of body weight per minute: initial 0.3 to 1 μg / kg per minute, average 3 μg / kg per minute and maximum in adults 8 μg / kg per minute And in children 10 μg / kg per minute. With controlled hypotension during a surgical operation under anesthesia or against the background of taking antihypertensive drugs for a 3-hour infusion, the drug is usually enough to introduce a total dose of 1 mg / kg,

When administered at a rate of 3 μg / kg per minute, blood pressure is usually reduced to 60 to 70% of the baseline, ie, 30 to 40%.