Q: If a patient requires sodium nitroprusside infusion, what are the few precautions which may prevent cyanide poisoning?
Answer: Patients who require higher and prolonged infusions of Sodium nitroprusside, and patients with renal insufficiency are prone to cyanide poisoning. Over the years, the use of sodium nitroprusside is decreased in the United States due to these concerns.
Applying silver foil on IV tubing prevents light from decomposing the nitroprusside molecule. Other preventive measures include not to exceed the infusion beyond 2 mcg/kg per minute, and adding sodium thiosulfate to the nitroprusside solution.
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References:
1. Bryson, PD. Comprehensive Review in Toxicology for Emergency Clinicians, 3rd, Taylor and Francis, Denver 1996. p.352.
2. The New York Poision Control Center. An Intensive Review Course in Clinical Toxicology, 2005. p.141.
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