Nipride - General Information
Nipride serves as a source of nitric oxide, a potent peripheral vasodilator that affects both arterioles and venules (venules more than arterioles). Nipride is often administered intravenously to patients who are experiencing a hypertensive emergency. [Wikipedia]
Pharmacology of Nipride
Nipride a powerful vasodilator relaxes the vascular smooth muscle and produce consequent dilatation of peripheral arteries and veins. Other smooth muscle (e.g., uterus, duodenum) is not affected. Sodium nitroprusside is more active on veins than on arteries.
Nipride for patients
The hypotensive effect of sodium nitroprusside is augmented by that of most other hypotensive drugs, including ganglionic blocking agents, negative inotropic agents, and inhaled anesthetics.
Sodium nitroprusside should not be used in the treatment of compensatory hypertension, where the primary hemodynamic lesion is aortic coarctation or arteriovenous shunting.
Sodium nitroprusside should not be used to produce hypotension during surgery in patients with known inadequate cerebral circulation, or in moribund patients (A.S.A. Class 5E) coming to emergency surgery.
Patients with congenital (Leber's) optic atrophy or with tobacco amblyopia have unusually high cyanide! thiocyanate ratios. These rare conditions are probably associated with defective or absent rhodanase, and sodium nitroprusside should be avoided in these patients.
Sodium nitroprusside should not be used for the treatment of acute congestive heart failure associated with reduced peripheral vascular resistance such as high-output heart failure that may be seen in endotoxic sepsis.
Additional information about Nipride
Nipride Indication: For immediate reduction of blood pressure of patients in hypertensive crises, reduce bleeding during surgery, and for the treatment of acute congestive heart failure
Mechanism Of Action: One molecule of sodium nitroprusside is metabolized by combination with hemoglobin to produce one molecule of cyanmethemoglobin and four CN- ions; methemoglobin, obtained from hemoglobin, can sequester cyanide as cyanmethemoglobin; thiosulfate reacts with cyanide to produce thiocyanate; thiocyanate is eliminated in the urine; cyanide not otherwise removed binds to cytochromes. Cyanide ion is normally found in serum; it is derived from dietary substrates and from tobacco smoke. Cyanide binds avidly (but reversibly) to ferric ion (Fe+++), most body stores of which are found in erythrocyte methemoglobin (metHgb) and in mitochondrial cytochromes. When CN is infused or generated within the bloodstream, essentially all of it is bound to methemoglobin until intraerythrocytic methemoglobin has been saturated.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Nitroprusside
Synonyms: Disodium nitroprusside dihydrate; Sodium nitroprusside extra pure; Sodium nitroprusside dihydrate; Sodium Nitroprusside; Sodium nitroferricyanide dihydrate
Drug Category: Antihypertensive Agents; Vasodilator Agents; Indicators and Reagents; Nitric Oxide Donors
Drug Type: Small Molecule; Approved
Absorption: Not Available
Toxicity (Overdose): Overdosage of nitroprusside can be manifested as excessive hypotension or cyanide toxicity or as thiocyanate toxicity. The acute intravenous mean lethal doses (LD50) of nitroprusside in rabbits, dogs, mice, and rats are 2.8, 5.0, 8.4, and 11.2 mg/kg, respectively.
Protein Binding: Not Available
Biotransformation: Metabolized by reaction with hemoglobin to produce cyanmethemoglobin and cynide ions
Half Life: Approximately 2 minutes
Dosage Forms of Nipride: Powder, for solution Intravenous
Chemical IUPAC Name: iron(+4) cation; oxoazanide; pentacyanide
Chemical Formula: C5FeN6O-2
Nitroprusside on Wikipedia: https://en.wikipedia.org/wiki/Nitroprusside
Organisms Affected: Humans and other mammals