Question
Sodium nitroprusside
Q3 3 marks Short Notes ★ ✓
Answer
Sodium nitroprusside is a potent, short-acting parenteral vasodilator.
Mechanism of action
Releases nitric oxide non-enzymatically, which activates guanylyl cyclase → increases cGMP → relaxes both arteriolar and venous smooth muscle (balanced arterial and venous dilator)
Uses
Hypertensive emergencies (given as IV infusion, rapid onset, easily titratable)
Acute severe heart failure (reduces preload and afterload)
Controlled hypotension during surgery
Adverse effects
Cyanide toxicity — nitroprusside is metabolized to cyanide, which is further converted to thiocyanate; accumulates with prolonged use or renal/hepatic impairment
Thiocyanate toxicity (with prolonged infusion) — tinnitus, confusion, psychosis
Hypotension
Requires protection from light (photodegradation) and continuous BP monitoring during infusion
1 Antihypertensives
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