There are many drugs that have antihypertensive effects. Drugs that lower blood pressure are usually used in combination and systematically (1-2 times a day). Thus, hypertension is treated. In some cases, conventional blood pressure medications do not work. Then stronger medicines are used, such as sodium nitroprusside solution. This drug is not used systematically and without serious need. It is not the drug of choice for the treatment of arterial hypertension, as well as chronic heart failure. It is used only in emergency cases, when the human body does not respond to other drugs that reduce blood pressure (diuretics, ACE inhibitors). Sodium nitroprusside solution cannot be administered independently, without a doctor's prescription.
What effect does the drug have on the body?
Drug "Sodium Nitroprusside" (formula - C5FeN6Na2O) belongs to the groupperipheral vasodilators. It is presented by substance of dark red color in the form of crystals or powder. But when preparing it, it is diluted with water and used only in liquid form. Due to the fact that the substance contains a nitroso group, the use of the drug causes vasodilation. This happens as follows: this chemical compound, when it enters the body, turns into nitric oxide and activates the enzyme - guanylate cyclase. As a result, the formation of cGMP is enhanced, which tends to accumulate in the smooth muscles of the vessels and causes its relaxation. Based on this, the drug "Sodium Nitroprusside" has the following effects: arterio- and venodilating, as well as hypotensive. Thanks to this, the work of the vascular system is quickly getting better. In addition, the solution acts like cardiac glycosides, that is, it reduces myocardial oxygen demand. This effect is achieved by reducing pre- and afterload.
Indications for the use of the medication
It should be understood that the drug is used only in emergency cases for serious diseases and resistance of the organism to other groups of drugs. Indications for the use of the drug are called:
- Acute heart failure. In particular, this refers to the development of pulmonary edema (cardiac asthma). The drug quickly prevents this condition in the absence of the effect of diuretics.
- Chronic heart failure severe. Extreme stages of CHF (2 b, 3) are notalways treatable. Therefore, with resistance to other drugs and a serious condition of the patient, peripheral vasodilators are prescribed.
- Acute coronary syndrome. In some cases, the drug is used for myocardial infarction to relieve pressure in the vessels of the heart, as well as to avoid the development of cardiogenic shock.
- Arterial hypertension unresponsive to traditional treatment. Vasodilators can be used for pheochromocytoma, paroxysmal crises, as well as the development of severe complications caused by a sharp increase in blood pressure (stroke, psychogenic disorders, heart attack).
- Ergot poisoning. This plant causes a sharp vasospasm, which can be weakened with the help of sodium nitroprusside medication. The instructions for use enclosed in the package should be well studied by emergency doctors and resuscitators.
Contraindications and side effects
The drug should not be used in hemorrhagic stroke, as well as after it. It is contraindicated in people suffering from chronic renal failure and hypothyroidism. Also, it is not recommended for people with increased intracranial pressure. The use of the drug is prohibited for children, pregnant women and people in old age. Another contraindication is intolerance to the active substance with the development of allergic reactions.
Among the side effects from the use of the drug "Nitroprusside sodium" it is worth highlighting a sharp decrease in blood pressure (in this case, you must immediatelystop administering it), increased heart rate, dizziness, general weakness and nausea.
Chemical reaction with sodium nitroprusside
In addition to providing a therapeutic effect, the substance sodium nitroprusside is used in chemical reactions. If it is mixed with a ketone body (acetone) and placed in an alkaline environment, an amazing color change of this compound can be seen. For such transformations, 4 test tubes are used. Only 1 substance is placed in each - sodium nitroprusside, acetone, alkali, acetic acid. In the first case, the resulting solution acquires a bright orange-red hue. This compound is then diluted with acetic acid. The color changes again, this time the liquid becomes dark red or purple.
Drug "Nitroprusside sodium": instructions for use
In order to administer medication, you need to get intravenous access. Immediately before starting the infusion of the drug, it must be diluted in a 5% glucose solution. To do this, 1 ampoule of the drug is drawn into a syringe and diluted in 5 ml of liquid. The resulting mixture is injected into a vial with 5% glucose to dissolve again. After that, the required dosage is selected. It varies from 0.3 to 8 mcg per 1 kg of body weight. The injection is made through the system. It should be started with a small dose, gradually increasing it under the control of vital signs (BP, heart rate, pulse). It is also necessary to establish an acceptable infusion rate of 2.5-3 mcg/kg per minute. Dosage depends ontime of drug administration. With prolonged infusion, it is necessary to monitor the level of cyanide containing sodium nitroprusside in the medication. Instructions for using the drug must be strictly followed.
Interaction with other drugs
The use of the drug and other antihypertensive drugs is not recommended, since a shock state may develop. You should be aware that the use of oral contraceptives reduces the effectiveness of the medication. When combining the drug with the drug "Dobutamine", it is necessary to carefully monitor the patient's vital signs (possibly reduced pressure, jamming in the vessels of the lungs, as well as an increase in cardiac output).
