SODIUM NITROPRUSSIDE DIHYDRATE
|Reviewed by Dr
David Knight and Dorothy Cooper
Management of Sodium Nitroprusside Administration
- A reddish-brown powder for reconstitution 50 mg in amber coloured vials. Soluble in water.
- Reconstituted solution has a faint brownish tinge.
- Do NOT use if it is highly coloured.
Charted on fluid chart giving:
- rate in ml/hour
- dose in micrograms/kg/minute
Also charted on drug chart under continuous infusions giving:
- amount of drug to be added
- base fluid, type and volume
Continuous IV Infusion
- Administered by a nurse with Neonatal IV Drug Certification.
- Reconstitute with D5W to 10 mg/ml immediately prior to use.
D5W to be added:
50 mg in 5.0 ml
- Dilute to make 100 mcg/ml in D5W by adding 5 mg sodium nitroprusside to make 50ml with D5W. Do NOT
use any other diluent. Mix well. Filter prior to administration through a 5
- Cover tubing and syringe in aluminium foil or other opaque material to protect from light.
- Compatible ONLY with D5W.
Do NOT mix with other drugs, IV solutions, blood or blood products.
Use a separate line for sodium nitroprusside. Do NOT flush line.
- Administer via a syringe pump.
- Change solution and tubing every 24 hours.
- Discard solution if any change in colour occurs.
Observation and Documentation
- Assess for signs of adverse effects.
- Continuous cardiorespiratory monitoring.
- Continuous blood pressure monitoring.
- Monitor arterial blood gases for metabolic acidosis.
- Monitor fluid balance.
- Document vital signs hourly.
- Monitor Hb. Nitroprusside binds to Hb.
- At room temperature <30°C until reconstitution.
- Protect from light, heat and moisture.
- Reconstituted solutions should be protected from light by covering with tinfoil. Diluted solutions discard
every 24 hours.
Roberts RJ. Drug therapy in infants: Pharmacologic principles and
clinical experience. Philadelphia, WB Saunders, 1984; p 184-86.
Greaney M, Saunders R (eds). NE Compendium: Detailed prescribing
information. Auckland, Adis Press 1990; p129-31.
Pawlak RP, Herfert LAT. Drug administration in the NICU. 2nd Ed 1991.
Neonatal Network p190-191.