Medication Description: Sodium nitroprusside (Natrium nitroprussid)
SODIUM NITROPRUSID (Natrium nitroprussid).
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 filler) in the form of a lyophilized porous mass or powder from cream to pinkish cream color. Easily soluble in water.
It is a highly effective peripheral vasodilator. Expands arterioles and partially veins. When administered intravenously, it has a fast, strong and relatively short hypotensive effect; reduces stress on the heart and myocardial oxygen demand.
Based on current data, the mechanism of the drug's action is associated with the vasodilator action of the nitroso group (NO), which is linked through the CN groups with an iron atom.
The antihypertensive effect after intravenous administration develops in the first 2–5 minutes, and 5–15 minutes after the end of the administration, the blood pressure returns to its original level.
Sodium nitroprusside is used in complex therapy for acute heart failure, especially in cases resistant to the usual therapeutic measures. The introduction of the drug quickly suppresses signs of cardiac asthma and threatened pulmonary edema and improves the performance of cardiac hyodynamics.
Sodium nitroprusside is injected briefly, then transferred to conventional therapy (diuretics, cardiac glycosides, etc.).
Applied also PNDS crises to quickly lower blood pressure, especially hypertension, complicated by acute heart failure, including acute myocardial infarction, hypertensive encephalopathy, cerebral hemorrhage, pheochromocytoma, sometimes with the syndrome Reynaud and vascular spasm caused by poisoning by ergot.
The drug is administered intravenously; when ingested, does not have hypotensive action.
Sodium nitroprusside solution is prepared immediately before use. First, dissolve the contents of one ampoule (25 or 50 mg) in 5 ml of 5% glucose solution, and then dilute an additional 1000; 500 or 250 ml of 5% glucose solution. At a dilution of 50 mg of the drug in a 500 ml solution, 1 ml contains 100 μg (at a dilution of 250 or 1000 ml, respectively 200 or 50 μg).
The use of undiluted solution is not allowed.
For infusions lasting up to 3 hours, the following doses are recommended based on 1 kg of body weight per minute: initial 0.3 - 1 mcg / kg per minute, average 3 mcg / kg per minute and the maximum in adults 8 mcg / kg per minute and in children 10 mcg / kg per minute. With controlled hypotension during surgery under anesthesia or against the background of taking antihypertensive drugs for a 3-hour infusion, it is usually sufficient to administer the drug in a total dose of 1 mg / kg,
With the introduction of a speed of 3 µg / kg per minute, blood pressure is usually reduced to 60 - 70% of the initial level, i.e., 30 - 40%.