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Pharmacology

Cardiovascular

Question 61 of 180

Sodium nitroprusside is contraindicated in which of the following:

Answer:

Sodium nitroprusside is contraindicated in
  • Compensatory hypertension
  • Leber’s optic atrophy
  • Severe vitamin B12 deficiency

Sodium Nitroprusside

Pharmacology / Cardiovascular

Last Updated: 17th April 2019

Sodium nitroprusside decomposes in the blood to release nitric oxide, an unstable compound that causes vasodilation.

Indications

Sodium nitroprusside is indicated for

  • Hypertensive emergencies
  • Controlled hypotension in anaesthesia during surgery
  • Acute or chronic heart failure

Contraindications

It is contraindicated in

  • Compensatory hypertension
  • Leber’s optic atrophy
  • Severe vitamin B12 deficiency

Cautions

It is should be used with caution in

  • Elderly
  • Hyponatraemia
  • Hypothermia
  • Hypothyroidism
  • Impaired cerebral circulation
  • Ischaemic heart disease

Side Effects

Side effects associated with over rapid reduction in blood pressure include: headache, dizziness, nausea, retching, abdominal pain, perspiration, palpitation, anxiety, retrosternal discomfort; the infusion rate should be reduced if any of these side effects occur.

Side effects caused by excessive plasma concentration of the cyanide metabolite include tachycardia, sweating, hyperventilation, arrhythmias, marked metabolic acidosis; the drug should be discontinued and the cyanide antidote given if these effects occur.

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Close
  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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