SODIUM NITROPRUSSID (Natrium nitroprussid).

     Sodium nitrozilpentatsianoferrat.

     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 a dried mass of powder or cream to rozovatokremovogo color. The easily soluble in water.

     He is a highly peripheral vazodilatatorom. Expands arterioly and partly vein. When intravenously provides fast, strong and relatively short anti-hypertensive effect; Reduces stress on the heart attack and needs oxygen.

     Based on current data, the mechanism of drug action associated with vazodilatatornym nitrozogruppy (NO), which is connected via C N atom of iron.

     Anti-hypertensive effect after intravenous develops in the first 2 to 5 minutes, and after 5 to 15 minutes after the introduction of AD back to the original level.

     Applied sodium nitroprusside in adjuvant therapy in acute heart failure, particularly in cases that are resistant to conventional therapeutic activities. Introduction drug fast heart pain signs of asthma and threatening swelling of the lungs and improves cardiac performance gimodinamiki.

     Enter sodium nitroprusside briefly, and then moved on to a conventional therapy (Diuretics, heart diseases, etc.).

     Applied also PNDS crises for the rapid downward AD, especially in hypertension, acute congestive heart failure patients, including those with severe heart attack, hypertensive encephalopathy, cerebral krovotecheniyah, feohromotsitome, sometimes with the syndrome Reynaud and vascular spasm caused by poisoning LPV.

     The drug is injected; When administered anti-hypertensive action will not help.

     A solution of sodium nitroprussida prepared immediately before use. First dissolve the contents of one vial (25 or 50 mg) in 5 ml of 5% glucose solution, and then grow further in 1000; 500 or 250 ml of 5% glucose solution. In grow 50 mg drug in 500 ml 1 ml of 100 µ g (with breeding in 250 or 1000 ml, respectively, 200, or 50 µ g).

     Application divorced solution is not allowed.

     When Infusion, continuing until 3 h following recommended doses per 1 kg of body weight per minute : the initial 0.3-1 µ g / kg per minute, average 3 µ g / kg per minute and a maximum of adults 8 µ g / kg per minute. and the children of 10 µ g / kg per minute. In controlled hypotension during surgery under anaesthesia or against admission antigipertenzivnyh preparations for the three-hour Infusion product usually enough to put in a total dose of 1 mg / kg,

     In imposing a speed of 3 µ g / kg per minute, AD usually falls to 60-70% of the initial level, that is, at 30-40%. In the long-term Infusion (days a week), the average rate of no more than 2, 5 ug / kg / min, which corresponds to 3, 6 mg / kg per day. That would keep the contents of cyanide in blood or plasma concentration which should not exceed 100 µ g in the blood of 100 ml and plasma 8 µ g per 100 ml. If Infusion continues more than 3 days, should monitor the content thiocyanate concentration which should not exceed 6 mg in 100 ml of serum.

     In tahifilaksii to sodium nitroprussidu when anti-hypertensive effect of the drug waned because of compensatory responses (often this occurs among young adults), the maximum doses above, can exceed.

     Speed Infusion, ie dose of a drug that comes in blood in a single month, set individually under constant control of AD.

     Use freshly solutions. Immediately after cooking liquor and fill the drip system for the introduction of measures to protect the drug from the light obertyvaya receptacle with mortar and parts of the system non-transparent black paper, plastic or metal foil attached to the package.

     Sodium nitroprusside is highly vazodilatatorom peripheral, but it must be applied with great caution.

     A solution must be carefully monitored by AD; Systolic pressure will be reduced to no more than 100 to 110 mm Hg. Art. In high concentrations, and the rapid introduction of possible rapid decline AD, tachycardia, vomiting, dizziness, unconscious. Then, the dose should be reduced (to slow introduction), or a complete halt to the introduction of the drug.

     Heavy overdose can cause the same phenomenon as in the case of cyanide poisoning. In these cases, a specific antidotnaya therapy (the use metgemoglobinoobrazovateley, metilenovogo blue, sodium thiosulfate).

     Recently, for this purpose recommended oksikobalamin (see); He reacts with the free cyanide into a tsianokobalamin (vitamin B) (see). For termination of sodium nitroprussida suspend its Infusion and injected (within 15 min) solution oksikobalamina dose equivalent to a double dose of sodium summarioy nitroprussida. Troop solution oksikobalamina produce grown 0.1 g per 100 ml of 5% glucose solution. Following oksikobalaminom injected (within 15 min), sodium thiosulfate solution (12, 5 g in 50 ml of 5% glucose solution). In severe cases, re-introduce it.

     Sodium nitroprusside should be applied with caution to people age, with hypothyroidism, disrupting kidney function (an organism derived from the kidneys); It is not recommended for children and pregnant.

     Contraindications : increased intracranial pressure, arteriovenozny bypass, koarktatsiya lakes, visual nerve atrophy, glaucoma. In emergency situations (for health), these are relative contraindications.

     Product : in ampoules containing 0.025 and 0.05 g (25 and 50 mg) of sodium nitroprussida injection.

     Storage : List B. In the dark, cool place.

     Naniprus (Bulgaria) issued dark glass ampoules containing 30 mg sodium nitroprussida, accompanied vials solvent (5 ml).

Materials allowed to copy only with the active hyperlink to the handbook of medicines