Emergency Drugs · Direct nitric oxide donor (arterial + venous dilator)
Sodium nitroprusside
Dose
Start 0.25–0.3 mcg/kg/min IV, titrate up to max 10 mcg/kg/min.
Indications
- • Hypertensive emergency (esp aortic dissection with β-blocker)
- • Afterload reduction in severe HF
Contraindications
- • Compensatory HTN (raised ICP without brain protection)
- • Severe hepatic/renal impairment (thiocyanate)
Dilution & preparation
50 mg in 250 mL D5W = 200 mcg/mL; protect from light
Use
Monitoring
Side effects
- • Cyanide toxicity (acidosis, ↑lactate — treat with hydroxocobalamin)
- • Coronary steal
- • Reflex tachycardia
Related in WardRound
Hyperkalaemia
Protocol · K⁺ > 5.5 mmol/L
Tricyclic Antidepressant Overdose
Protocol · QRS widening = give bicarbonate
Salicylate Poisoning
Protocol · Alkaline diuresis + dialysis
Cyanide Poisoning
Protocol · Hydroxocobalamin
Methanol / Ethylene Glycol Poisoning
Protocol · Fomepizole + dialysis
Aluminium Phosphide Poisoning
Protocol · Coconut oil + supportive
Epilepsy
Topic · Neurology
TCA Overdose
Topic · Toxicology
Always confirm dose against your local formulary / BNF before prescribing.
