ニトロプルシドナトリウム

使用用途

• Hypertensive crisis (systolic arterial BP >200 mm Hg)
• Adjunctive treatment of heart failure (cardiogenic shock; fulminant pulmonary edema)
• Adjunctive treatment of heart failure
• Catastrophic pulmonary edema
• Hypertensive crisis (systolic arterial BP >200 mm Hg)
• Adjunctive treatment of heart failure (cardiogenic shock; fulminant pulmonary edema)
• Adjunctive treatment of heart failure
• Catastrophic pulmonary edema

投与方法

考えられる副作用

• Profound hypotension
• Nausea
• Retching
• Restlessness
• Apprehension
• Muscle twitching
• Dizziness
• Infusion site irritation (avoid extravasation)
• Thiocyanate and cyanide toxicity (with prolonged use)

注意事項と禁忌

• Compensatory hypertension (e.g., AV shunts, coarctation of the aorta, Cushing's reflex)
• Inadequate cerebral circulation
• Emergency surgery in patients near death
• > **CRITICAL WARNING**: Must only be used in an ICU setting with continuous blood pressure monitoring. * **Organ Impairment**: Use with extreme caution in patients with hepatic insufficiency, severe renal impairment, hyponatremia, or hypothyroidism due to increased risk of thiocyanate/cyanide toxicity. * **Surgical Use**: When used for controlled hypotension during surgery, patients have less tolerance to hypovolemia, anemia, or blood loss. * **Geriatrics**: Older patients may be more sensitive to hypotensive effects. * **Pregnancy**: FDA Category C. Animal studies show adverse fetal effects. Use cautiously as a last resort when benefits clearly outweigh risks. Unknown if excreted in milk.

薬物相互作用

• General Anesthetics (e.g., halothane, enflurane): May enhance the hypotensive effects of nitroprusside.
• Dobutamine: Synergistic effects (increased cardiac output and reduced wedge pressure) may result; often used together beneficially in severe heart failure.
• Other Hypotensive Agents (e.g., beta-blockers, ACE inhibitors): Patients may be more sensitive to the hypotensive effects of nitroprusside.

よくある質問