81
Comments
Contraindicated in advanced aortic stenosis; no dose adjustment needed for persons
aged ≥65 y. No negative inotropic or chronotropic effects.
Contraindicated in patients with soybean, soy product, egg, and egg product allerg y
and in patients with defective lipid metabolism (eg, pathological hyperlipidemia, lipoid
nephrosis [minimal change disease] or acute pancreatitis). No negative inotropic or
chronotropic effects. Decreased risk of reflex tachycardia.
Due to potency, intra-arterial BP monitoring is recommended to prevent "overshoot."
Lower dose required for older adults. Tachyphylaxis is common with extended use.
No negative inotropic or chronotropic effects.
Due to increased mortality risk, should be avoided in acute cerebrovascular disease
unless other agents are not available. Use cautiously in pregnancy or older adults.
Cyanide toxicity (increased risk in liver dysfunction and chronic kidney disease)
and thiocyanate toxicity (increased risk in kidney dysfunction, sCr >3) may occur
for infusion rates ≥3 mcg/kg/min and/or duration ≥3 days. Cyanide toxicity and
thiocyanate toxicity may present similarly with metabolic acidosis, altered mental status,
and cardiac arrhythmia. For either toxicity state, nitroprusside should be discontinued
and sodium thiosulfate or cyanocobalamin should be administered.
Use only in patients with acute coronary syndrome and/or acute pulmonary edema.
Do not use in volume-depleted patients. Tachyphylaxis is common with extended use.
BP begins to decrease within 10–30 min, and the fall lasts 2–4 h. Hydralazine is an
undesirable first-line agent for acute treatment in most patients due to unpredictability
of response and prolonged duration of action.
Contraindicated in patients with concurrent beta-blocker therapy, bradycardia, or
decompensated HF. Monitor for bradycardia.
Higher doses may block beta-2 receptors and impact lung function in reactive airway
and obstructive pulmonary disease.
