Description of the medicine: Sodium nitroprusside (Natrium nitroprussid)
SODIUM NITROPRUSSID (Natrium nitroprussid).
Synonyms: Naniprus, Niprid, Nipruton, Hypoten, Nanipruss, Natrium nitroprussicum, Nipride, Niprus, Nipruton, Sodium nitroprusside.
Russet crystals (or powder).
Available for injection (with the addition of filler) in the form of a lyophilized porous mass or powder from cream to pink cream color. Easily soluble in water.
It is a highly effective peripheral vasodilator. Expands arterioles and partially veins. When administered intravenously, it has a quick, strong and relatively short hypotensive effect; reduces the load on the heart and myocardial oxygen demand.
Based on current data, the mechanism of action of the drug is associated with the vasodilator action of the nitroso group (NO), connected through the CN group to the iron atom.
The antihypertensive effect after intravenous administration develops in the first 2–5 minutes, and after 5–15 minutes after the end of administration, blood pressure returns to its initial level.
Sodium nitroprusside is used in complex therapy for acute heart failure, especially in cases resistant to conventional therapeutic measures. The introduction of the drug quickly eliminates the signs of cardiac asthma and threatening pulmonary edema and improves cardiac hemodynamics.
Sodium nitroprusside is administered briefly, then they switch to conventional therapy (diuretics, cardiac glycosides, etc.).
It is also used for hypertensive crises to quickly lower blood pressure, especially for hypertension complicated by acute heart failure, including acute myocardial infarction, hypertensive encephalopathy, cerebral hemorrhage, pheochromocytoma, sometimes with Raynaud's syndrome and vascular spasms caused by ergot poisoning.
The drug is administered intravenously; when ingested does not have a hypotensive effect.
A solution of sodium nitroprusside is prepared immediately before use. First, the contents of one ampoule (25 or 50 mg) are dissolved in 5 ml of a 5% glucose solution, and then diluted additionally in 1000; 500 or 250 ml of 5% glucose solution. When diluting 50 mg of the drug in 500 ml of a solution, 1 ml contains 100 μg (when diluted in 250 or 1000 ml, 200 or 50 μg, respectively).
The use of undiluted solution 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 - 1 μg / kg per minute, average 3 μg / kg per minute and the maximum in adults is 8 μg / kg per minute and in children 10 mcg / kg per minute. With controlled hypotension during surgery under anesthesia or while taking antihypertensive drugs for a 3-hour infusion, it is usually sufficient to administer the drug in a total dose of 1 mg / kg,
When administered at a rate of 3 μg / kg per minute, blood pressure usually decreases to 60 - 70% of the initial level, i.e., by 30 - 40%.