Sodium Nitroprusside: The Forgotten Vasodilator? A Brief Guide for Informed and Safe Use from Heart Failure to Hypertensive Crisis and Aortic Dissection
Abstract
:1. Introduction
2. Materials and Methods
3. Sodium Nitroprusside: Pharmacology and Toxicology
4. Sodium Nitroprusside and Other Vasodilators: Hemodynamic Effect
5. Sodium Nitroprusside in Acute Heart Failure and Heart Transplant
Pulmonary Hypertension and Heart Transplant
6. Sodium Nitroprusside in Emergency Hypertension and Aortic Dissection
6.1. Hypertensive Emergency
6.2. Aortic Dissection
7. Sodium Nitroprusside in Pediatric Setting
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sign of Cyanide Toxicity | General Treatment | |
---|---|---|
Central nervous system | Mental status change Seizure Coma | STOP infusion SNP 100% Oxygen infusion (despite normal O2 saturation) Correction metabolic acidosis with HCO3 |
Cardiovascular instability | Hypertension ECG change (arrhythmia, ST depression) | 3% sodium nitrite 4/6 mg/kg IV slowly Sodium thiosulfate 150/200 mg/kg IV over 15 min (most utilized over for toxicity prophylaxis) |
Increasing metabolic acidosis | Increasing base deficit Lactate augmented | Consider Hydroxocobalamin (Vit B12) 25 mg/h |
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D’Elia, S.; Franzese, R.; Gentile, C.; Solimene, A.; Luisi, E.; Caiazzo, A.; Natale, F.; Loffredo, F.S.; Golino, P.; Cimmino, G. Sodium Nitroprusside: The Forgotten Vasodilator? A Brief Guide for Informed and Safe Use from Heart Failure to Hypertensive Crisis and Aortic Dissection. Future Pharmacol. 2025, 5, 1. https://doi.org/10.3390/futurepharmacol5010001
D’Elia S, Franzese R, Gentile C, Solimene A, Luisi E, Caiazzo A, Natale F, Loffredo FS, Golino P, Cimmino G. Sodium Nitroprusside: The Forgotten Vasodilator? A Brief Guide for Informed and Safe Use from Heart Failure to Hypertensive Crisis and Aortic Dissection. Future Pharmacology. 2025; 5(1):1. https://doi.org/10.3390/futurepharmacol5010001
Chicago/Turabian StyleD’Elia, Saverio, Rosa Franzese, Carmine Gentile, Achille Solimene, Ettore Luisi, Antonio Caiazzo, Francesco Natale, Francesco S. Loffredo, Paolo Golino, and Giovanni Cimmino. 2025. "Sodium Nitroprusside: The Forgotten Vasodilator? A Brief Guide for Informed and Safe Use from Heart Failure to Hypertensive Crisis and Aortic Dissection" Future Pharmacology 5, no. 1: 1. https://doi.org/10.3390/futurepharmacol5010001
APA StyleD’Elia, S., Franzese, R., Gentile, C., Solimene, A., Luisi, E., Caiazzo, A., Natale, F., Loffredo, F. S., Golino, P., & Cimmino, G. (2025). Sodium Nitroprusside: The Forgotten Vasodilator? A Brief Guide for Informed and Safe Use from Heart Failure to Hypertensive Crisis and Aortic Dissection. Future Pharmacology, 5(1), 1. https://doi.org/10.3390/futurepharmacol5010001