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Nitroprusside

Sodium Nitroprusside Toxicity


Presentation

  • We present a 30 2-weeks-old (30 weeks and 2 days) male, twin 1, born by emergency caesarean section due to twin-twin transfusion syndrome (absent end-diastolic flow and cardiac anomaly in twin 2) presenting with hypertensive crisis on day 3.[ncbi.nlm.nih.gov]
  • Presentation can be severe and associated with hypertension. Dramatic benefit from infused nitroprusside suggests the disorder could represent a dysfunctional endothelium.[ncbi.nlm.nih.gov]
  • Details of presentation, diagnosis and successful treatment are given.[ncbi.nlm.nih.gov]
  • We present the central haemodynamic data obtained during halothane/nitrous oxide anaesthesia in a patient under antihypertensive treatment with propranolol who underwent surgery for intracranial aneurysms in sodium nitroprusside-induced hypotension.[ncbi.nlm.nih.gov]
  • A case report is presented for a patient with nitroprusside-induced cyanide intoxication. The patient received approximately 1 g sodium nitroprusside through an intravenous infusion of the drug over 6 d.[ncbi.nlm.nih.gov]
Gangrene
  • Peripheral vasoconstriction may lead to gangrene of the extremities, necessitating amputation. Various treatments have been tried against ischemic complications during ergotism with varied and unpredictable results.[ncbi.nlm.nih.gov]
Euthyroid
  • In the SNP group, free T3 values stayed in the euthyroid range between CPB and post-CPB periods, the period when SNP was infused, whereas it continued to decline to hypothyroidic levels in the control group.[ncbi.nlm.nih.gov]
Hypotension
  • This is the longest known use of sodium nitroprusside for deliberate hypotension during surgery which emphasizes the safety of this hypotensive technique, provided the total dosage of sodium nitroprusside is reasonable.[ncbi.nlm.nih.gov]
  • PURPOSE: The present study sought to determine whether premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside could reduce reflex tachycardia, the amount of sodium nitroprusside used, and blood loss during hypotensive[ncbi.nlm.nih.gov]
  • Sodium nitroprusside (SNP) is a powerful, peripherally acting hypotensive agent with a rapid onset but short duration of action.[ncbi.nlm.nih.gov]
  • […] nitroprusside (SNP) or nitroglycerin (NTG) as the hypotensive agent. 36 patients, who were scheduled to undergo mandibular osteotomy, were recruited for the study.[ncbi.nlm.nih.gov]
  • Sodium nitroprusside, contrary to SIL, was associated with systemic arterial hypotension and worsening of venous oxygen saturation.[ncbi.nlm.nih.gov]
Tachycardia
  • CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside is safe and effective to reduce reflex tachycardia and the amount of sodium nitroprusside used.[ncbi.nlm.nih.gov]
  • […] increased by hypothermia, malnutrition, vitamin B12 deficiency, hepatic or renal impairment related to rate of infusion rather than total dose. cyanide ion combines with cytochrome C - impairment of aerobic metabolism - metabolic lactic acidosis signs: tachycardia[lifeinthefastlane.com]
  • Sodium Nitroprusside (Nipride ) Class: Potent vasodilator Actions: converts to nitric oxide, a potent vasodilator Venous dilation reducing preload Arteriolar dilation reducing afterload Triggers retention of sodium and water Minimal reflex tachycardia[shadwige.sites.truman.edu]
  • Symptoms: Cyanide toxicity is often associated with the odor of almonds on breath and can result in acidosis, tachycardia, mental status changes, and death.[openanesthesia.org]
  • Increased heart rate (tachycardia). The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.[netdoctor.co.uk]
Retinal Pigmentation
  • Abstract The pathological increase in the levels of the second messenger nitric oxide (NO) in the vitreous cavity and retina leads to injury and cell death of the retinal pigment epithelium (RPE) cells and eventually may contribute to the occurrence and[ncbi.nlm.nih.gov]
Burning Sensation
  • Taken together with our previous experience, we believe sodium nitroprusside administration to be a treatment of choice for erythromelalgia, in which the constant pain and burning sensation make the patient extremely restless.[ncbi.nlm.nih.gov]

Workup

Hepatocellular Carcinoma
  • Abstract This study aims to explore which radicals dominate sodium nitroprusside (SNP)-induced cytotoxicity in human hepatocellular carcinoma (HCC) cells (HepG2 and Hep3B).[ncbi.nlm.nih.gov]

Treatment

  • The diagnosis of severe delayed cerebral vasospasm refractory to conventional treatment (HHH therapy and nimodipine) was established before treatment.[ncbi.nlm.nih.gov]
  • Various treatments have been tried against ischemic complications during ergotism with varied and unpredictable results.[ncbi.nlm.nih.gov]
  • Abstract This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD).[ncbi.nlm.nih.gov]
  • Animal and human research supports that CBD and sodium nitroprusside might be effective in the prevention and treatment of psychosis in general and especially in schizophrenia.[ncbi.nlm.nih.gov]
  • A 3 hours treatment with 0.1 µM Ca2 ionophore ionomycin triggered annexin-V-binding and cell shrinkage, effects fully reversed by removal of extracellular Ca2 .[ncbi.nlm.nih.gov]

Prognosis

  • BACKGROUND: Pulmonary hypertension is associated with a worse prognosis after cardiac transplantation.[ncbi.nlm.nih.gov]
  • Comparison between the two groups revealed improvement in TCD velocities and GCS in the SNP group thus affecting the long-term prognosis.[ncbi.nlm.nih.gov]
  • Prognosis of congestive heart failure in patients aged greater than or equal to 62 years with unoperated severe valvular aortic stenosis. Am J Cardiol 1993 ;72: 846 - 848 3.[nejm.org]
  • . : Renal vein renin activity in the prognosis of surgery for renovascular hypertension . Amer. J. Med., 47; 860 ( 1969 ). Google Scholar Medline Bourcoignie, J. , Kurz, S. , Catanzaro, F. : Renal venous renin in hypertension . Amer. J.[journals.sagepub.com]

Etiology

  • The complex mutation of the NPPB gene might be an etiological factor of hereditary malignant hypertension, and it is associated with low sensitivity to the antihypertensive effect of sodium nitroprusside.[ncbi.nlm.nih.gov]

Epidemiology

  • The Office of Surveillance and Epidemiology review outlines several reasons why these data cannot be used to calculate incidence of adverse events in the population.[federalregister.gov]
Sex distribution
Age distribution

Pathophysiology

  • However, the pathophysiology of these anomalies has not been studied in depth.[ncbi.nlm.nih.gov]
  • Abstract Ecto-5'-nucleotidase (NT5E), a predominant enzyme that produces extracellular adenosine from AMP, plays an important role in a variety of physiological and pathophysiological processes.[ncbi.nlm.nih.gov]
  • An inverse relationship between baseline SVI and change in SVI with afterload reduction was observed, suggesting that heightened sensitivity to afterload is a significant contributor to LF-LGSAS pathophysiology.[ncbi.nlm.nih.gov]
  • Our finding supports the concept that nitric oxide is playing a critical part in the pathophysiology of cerebral vasospasm after subarachnoid haemorrhage and that intraventricular sodium nitroprusside may offer a a novel therapeutic option in patients[jnnp.bmj.com]
  • Pathophysiology of the heart failure clinical syndrome. In: Topol EJ, ed. Textbook of cardiovascular medicine. Philadelphia: Lippincott-Raven, 1998:2179-203. 30. Pepine CJ, Nichols WW, Curry RC Jr, Conti CR.[nejm.org]

Prevention

  • In Hep3B cells, pretreatment with NO scavenger (PTIO) did not prevent SNP-induced cytotoxicity.[ncbi.nlm.nih.gov]
  • Both UDCA (50-200 μM) and YS (100-200 μM) dose-dependently prevented SNP (1mM)-induced cell death.[ncbi.nlm.nih.gov]
  • Animal and human research supports that CBD and sodium nitroprusside might be effective in the prevention and treatment of psychosis in general and especially in schizophrenia.[ncbi.nlm.nih.gov]
  • However, it is uncertain whether the injection of nitroprusside at a specific time point during PPCI can most effectively prevent no-reflow.[ncbi.nlm.nih.gov]
  • Abstract The objective of this study was to evaluate the clinical efficacy and safety of nitroprusside injection for preventing the slow-flow/no-reflow phenomenon after percutaneous coronary intervention (PCI).[ncbi.nlm.nih.gov]

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