Nipride: Full Drug Profile

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

Nipride Interactions

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.

Nipride Contraindications

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.

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

Other Brand Names containing Nitroprusside

Nipride; Nitropress;

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.

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