Sodium Nitroprusside

Rf, Palmer; Kc, Lasseter

doi:10.1056/nejm197502062920606

Cited by 277 publications

(43 citation statements)

References 17 publications

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“…Further work with larger numbers of participants is necessary. Also, to avoid adverse effects resulting from the formation of cyanide or thiocyanate which may occur when doses higher than 5 mcg/kg/min of SNP are used, typically for a period greater than 24 hours 21 , SNP was used in this study in minimal doses (0.125; 0.25 and 0.5 mcg/kg/min), for a short period (75 minutes), and in a single infusion. The three doses of SNP showed no significant differences in any of the parameters evaluated.…”

Section: Discussionmentioning

confidence: 99%

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine – A translational double-blind study

Rezende

Maia‐de‐Oliveira

Kandratavicius

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

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Background: Recent evidence has shown improvements in schizophrenia symptoms after the infusion of sodium nitroprusside (SNP), a nitric oxide (NO) donor. In the rat model of schizophrenia using ketamine injection, pretreatment with SNP seems to prevent behavioral changes associated with positive symptoms for up to one week. Objective: We investigated whether SNP would have preventative effects on psychogenic symptoms induced by ketamine in healthy subjects. Methods: Healthy subjects (N = 38) were assigned to distinct groups that received SNP in different doses (0.15, 0.25, and 0.5 mcg/kg/min). First, participants received an infusion of SNP or placebo over 75 minutes. After 10 minutes, they were injected for 1 minute with a bolus of 0.26 mg/kg of ketamine and a maintenance dose was started 5 minutes later, with 0.25 mg/kg/h of ketamine for 50 minutes. Results: Ketamine-induced psychopathological alterations induced were reduced by SNP, as assessed with the Brief Psychological Rating Scale. Scores in the objective subscale of the Clinician-Administered Dissociative States Scale were also lower in SNP sessions compared to placebo. SNP had protective effects against deterioration in facial emotion and identity recognition tasks induced by ketamine. Discussion: Our findings support the view that SNP has preventative properties against psychotic manifestations.

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Section: Discussionmentioning

confidence: 99%

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine – A translational double-blind study

Rezende

Maia‐de‐Oliveira

Kandratavicius

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

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“…However, the dose and duration of therapy should be limited as much as possible because of the metabolism of this agent to thiocyanate and cyanide, which have determined fetal cyanide poisoning in animal models. 128 If nitroprusside is necessary, breastmilk feeding should be interrupted because thiocyanate is excreted into breast milk. 116 Intropes, such as dobutamine can be used in pregnant women if necessary for systolic dysfunction heart failure presenting with symptoms and signs of low cardiac output, unresponsive to medical therapy.…”

Section: Intravenous Therapymentioning

confidence: 99%

Pregnancy and heart disease: what Internists should know

Gerloni

Panuccio²

2017

Ital J Med

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Cardiac disease can rarely complicate pregnancy (e.g., only 1 to 4% of pregnancies in the United States), but it still remains a major cause of non-obstetric maternal morbidity and mortality. 1 During pregnancy, a woman can suffer from heart failure because of a pre-existing heart disease or a new onset cardiopathy pregnancy correlated. Approximately 2% of pregnancies involve cardiac disease, and in the current era, most maternal disease is due to congenital heart disease (CHD).2 Currently cardiac surgery improvement of the last 50 years has permitted an increased number of survivors. Instead, in the past, rheumatic heart disease was the leading cause of heart failure in pregnancy.3,4 Further, with increasing maternal age, other etiologies of heart disease should not be ignored and, particularly, ischemic and hypertensive heart disease should be considered in an over forty pregnant women. 5 Physiology of normal pregnancyImportant hemodynamic changes appear during pregnancy and are responsible for heart failure in pregnant women with pre-existing heart disease. These changes begin early in pregnancy, generally during the first eight weeks, reach their peak during the late second trimester, and then remain relatively constant until delivery. 6 The plasma volume and red cell mass are the first major cardiocirculatory modification, actually they expand in the 8 th week and peak around 30 th week, with a net plasma volume gain of 1000-1600 mL, corresponding to 30-50% above baseline.7 A greater increase in intravascular volume compared to red cell mass results in the dilutional anemia of pregnancy. This aspect generally results at 30-34 weeks when plasma volume peaks in relation to red cell mass and is associated with sodium and water retention. Actually 1000 mEq of sodium and 6 liters of water are retained and distributed among amniotic fluid, fetus and intra and extracellular spaces.8 Further cardiac output increases to satisfy increase fetal and maternal metabolic needs. It can be estimated 30-50% above baseline levels during the entire pregnancy, but half of this change occurs by 8 th week. This relevant change is a consequence of blood volume augmentation, afterload reduction and maternal heart rate rise.9 Systemic Pregnancy and heart disease: what Internists should know ABSTRACTPregnant women with heart disease are increasing due to medical and surgical progress and, nowadays, congenital heart disease is the most frequent heart disease affecting these women. Pregnancy represents a considerable effort for an altered heart with negative consequences for life quality, disease progression and mortality. Risk differs a lot among patients and depends not only on the type of heart disease. Clinician should stratify risk and offer patients a correct pre-counselling and accurate follow-up. At the same time Clinician should be able to diagnose rapidly heart failure as some cardiopathies, such as peripartum cardiomyopathy, are related to pregnancy and produce symptoms that can be confused with normal pregnancy progression...

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“…Sodium nitroprusside is a potent, direct-acting vasodilator which has been used for systemic hypertension (16), pulmonary hypertension (7), and congestive heart failure (6,17). Although experience with nitroprusside in the neonate is limited, two case reports (1,4) have suggested that nitroprusside may have a therapeutic role in decreasing the high pulmonary vascular resistance of hyaline membrane disease.…”

mentioning

confidence: 99%

The Effects of Sodium Nitroprusside on Blood Flow and Oxygen Delivery to the Organs of the Hypoxemic Newborn Lamb

Mirro

Milley

1985

Pediatr Res

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ABSTRACT. Vasodilators are used in newborns underconditions where hypoxia may be prominent. To study the effects of vasodilator therapy on organ oxygen delivery we measured blood flow (using radioactive microspheres) and arterial oxygen content in six chronically catheterized newborn lambs. Cardiac output and its distribution were measured during normoxia, hypoxia (10% O2 and 5% C02), and hypoxia with a nitroprusside infusion. Hypoxia decreased oxygen content but did not change heart rate, mean blood pressure, or cardiac output. When nitroprusside was infused during hypoxemia, oxygen content and heart rate were not affected, but mean arterial blood pressure fell (39% decrease). During hypoxemia, blood flow increased to the heart, brain, and carcass but decreased to the gastrointestinal tract. When nitroprusside was infused during hypoxemia, blood flow decreased to the heart, brain, kidneys, and carcass. Oxygen delivery (arterial Oz content x blood flow) decreased to the brain as well as to kidneys, stomach, and carcass when nitroprusside was given to the hypoxemic lamb. (Pediatr Res 19: 15-18, 1985)Hypoxemia often accompanies neonatal cardiopulmonary disease. Such common problems as hyaline membrane disease, pneumonia, aspiration syndromes, cyanotic congenital heart disease, and persistent fetal circulation may present with hypoxemia as a prominent finding (8,14,20). When conventional therapy (high inspired oxygen concentration and mechanical ventilation) fails to increase arterial Po2, phannacologic agents have been used. In general, drug therapy is aimed at increasing arterial oxygen content by increasing pulmonary blood flow and thus is employed primarily when pulmonary blood flow is thought to be reduced as a result of pulmonary arterial vasoconstriction.Sodium nitroprusside is a potent, direct-acting vasodilator which has been used for systemic hypertension (16), pulmonary hypertension (7), and congestive heart failure (6, 17). Although experience with nitroprusside in the neonate is limited, two case reports (1, 4) have suggested that nitroprusside may have a therapeutic role in decreasing the high pulmonary vascular resistance of hyaline membrane disease.Nitroprusside is an iron-coordinated complex surrounded by cyanide groups with a single nitroso group (16). The drug is metabolized in the liver to cyanide which is then quickly con- This research was supported by a Grant-in-Aid from the Western Pennsylvania Heart Association, Inc.verted to thiocyanate. Cyanide and thiocyanate may have toxic effects which result in tissue hypoxia and resultant metabolic acidosis. Thiocyanate levels of 10-20 mg/100 m1 (16) result in adverse clinical symptoms. As toxic products accumulate during infusion, hazard increases when the infusion is prolonged.Further information about the response of the newborn's systemic circulation to vasodilator therapy, especially under hypoxemic conditions, would help to show when their use is appropriate. The purpose of this experiment is to examine the effect of nitroprusside on the distri...

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Sodium Nitroprusside

Cited by 277 publications

References 17 publications

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine – A translational double-blind study

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine – A translational double-blind study

Pregnancy and heart disease: what Internists should know

The Effects of Sodium Nitroprusside on Blood Flow and Oxygen Delivery to the Organs of the Hypoxemic Newborn Lamb

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