Nitroprusside Toxicity and Low-Dose Infusion

Letters and Corrections1 June 1986Nitroprusside Toxicity and Low-Dose InfusionANNE B. CETNAROWSKI, Pharm.D., DAVID R. CONTI, M.D.ANNE B. CETNAROWSKI, Pharm.D.Search for more papers by this author, DAVID R. CONTI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-6-895_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Sodium nitroprusside is used extensively in the treatment of various cardiovascular emergencies. The toxicity profile of this drug requires frequent assessment of patients for signs of cyanide and thiocyanate toxicity, which may be elusive in view of concurrent diseases and medications. Prolonged infusions at doses well below the manufacturer's recommendations for maximum infusion rate, 10 µg/kg body weight ·min, are known to produce toxic accumulation of cyanide and thiocyanate (1, 2). We noted sodium nitroprusside toxicity at a dose rate that was 4 µg/kg · min or more for 14 hours, with a maximum rate of 4.9...References1. SCHULZGROSSPASCHLOESCHCKE VRTG. Cyanide toxicity of sodium nitroprusside in therapeutic use with and without sodium thiosulphate. Klin Wochenschr. 1982;60:1393-400. CrossrefMedlineGoogle Scholar2. RIEVES D. Importance of symptoms in recognizing nitroprusside toxicity. South Med J. 1984;77:1035-7. CrossrefMedlineGoogle Scholar3. VESEYCOLE CP. Blood cyanide and thiocyanate concentration produced by long-term therapy with sodium nitroprusside. Br J Anaesth. 1985;57:148-55. CrossrefMedlineGoogle Scholar4. PASCHSCHULZHOPPELSHAUSER TVG. Nitroprusside-induced formation of cyanide and its detoxication with thiosulfate during deliberate hypotension. J Cardiovasc Pharmacol. 1983;5:77-84. CrossrefMedlineGoogle Scholar5. GREISSTREMBLAYDAVIES LND. The toxicity of sodium nitroprusside. Can Anaesth Soc J 1976;23:480-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ANNE B. CETNAROWSKI, Pharm.D.; DAVID R. CONTI, M.D.Affiliations: Millard Fillmore Hospital Buffalo, NY 14209 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCyanide Toxicity in the Surgical Intensive Care Unit: A Case ReportTreatment of Hypertension in the Perioperative PatientRandomized, Prospective Trial of Fenoldopam vs Sodium Nitroprusside in the Treatment of Acute Severe HypertensionTreatment of Cyanide and Thiocyanate Toxicity Secondary to Sodium NitroprussideCyanide Toxicity from Sodium Nitroprusside: Risks and ManagementCyanide release from sodium nitroprusside during coronary bypass in hypothermiaComparative acute blood pressure reduction from intravenous fenoldopam mesylate versus sodium nitroprusside in severe systemic hypertension 1 June 1986Volume 104, Issue 6Page: 895-896KeywordsAdverse reactionsBody weightSodiumToxicity ePublished: 1 December 2008 Issue Published: 1 June 1986 PDF downloadLoading ...