SODIUM NITROPRUSSIDE

Sodium nitroprusside helps lower blood pressure, In patients with normal cardiac output. It is an emergency condition for when blood pressure is very high and can potentially lead to certain types of heart failure, and it is used during surgeries to decrease bleeding. Sodium nitroprusside shows immediate effect within minutes when intravenously infused, in cases of acute hypertensive crises. venous return and total peripheral resistance is reduced by Nitric oxide, both preload and afterload. This specialty makes it more effective in severe congestive heart failures where its combination of actions increases cardiac output. It also treats aortic valve stenosis, Oesophageal varices, pulmonary hypertension, myocardial infarction, respiratory distress syndrome in newborns, shock, and ergot toxicity. Sodium nitroprusside is sold under the brand names Nipride RTU and Nitropress amongst others. First discovered in 1849, it was not used in clinical treatment till 1922. It’s proven efficacy in treating a wide range of life threatening conditions worldwide has earned it a position on World Health Organization's List of Essential Medicines.

Forms and Dosage:

Sodium nitroprusside is sold in the form of an injection. Normally doses of 50 mg must be further diluted in 250-1000 mL of sterile 5% dextrose injection.

The price Sodium nitroprusside

In the USA, the consumers have to pay an retail price between $13.15 – $118.03 for 2ml supply of this injection depending on the brand being bought. However, this medicine is much cheaper in India, where a supply of 50ml of this medicine costs USD2.

How does Sodium nitroprusside work?

Sodium nitroprusside breaks down to nitric oxide, and has potent vasodilating effects on arterioles and veins more than arteries. It breaks down in circulation and releases nitric oxide by binding to oxyhaemoglobin to release cyanide, methaemoglobin and nitric oxide. nitric oxide then activates guanylate cyclase in vascular smooth muscle leading to an increased intracellular production of cGMP. cGMP activates protein kinase G which in turn activates phosphatases that finally inactivate myosin light chains. Myosin light chains contract muscles, resulting is vascular smooth muscle relaxation. This allow vessels to dilate. The actions are same as PDE5 inhibitors such as sildenafil and tadalafil that elevate cGMP concentration by inhibiting its degradation by PDE5.

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