10min to avoid the danger of cyanide toxicity. dangers of CN toxicity during NP administration and approaches to the detection of toxicity is not wide spread among physician-users or even among experts. Nitroprusside infusion rates more than 2 mcg/kg/minute generate cyanide ion faster than the body can normally dispose of it. Sodium nitroprusside or SNP is a chemical compound, often encountered as dihydrate. Initially 0.5–1.5 micrograms/kg/minute, adjusted in steps of 500 nanograms/kg/minute every 5 minutes, usual dose 0.5–8 micrograms/kg/minute, use lower doses if already receiving other antihypertensives, stop if response unsatisfactory with max. Seems like 5-10mcg/kg/minute of nitroprusside for 3-10 hours is enough to cause serious problems. This medicine is also used to reduce bleeding during surgery, and treats acute heart failure. Found inside – Page 13The initial dose of sodium thiosulfate is 50 mL , which is equivalent to one of ... cyanide toxicity from prolonged administration of sodium nitroprusside ... the cyanide from an additional 50 mg of nitroprusside is bound to thiosulfate to form thiocyanate, which is eliminated in the urine cyanide toxicity occurs when the total dose of nitroprusside exceeds the ability to eliminate the cyanide (total dose of 68 mg), or if thiosulfate stores are low (e.g. The acute intravenous mean lethal doses (LD 50) of nitroprusside in rabbits, dogs, mice, and rats are 2.8, 5.0, 8.4, and 11.2 mg/kg, respectively. Caution should be exercised by clinicians prescribing SNP, and SNP toxicity should be considered in case of unexplained lactic acidosis or absent clinical response shortly after reaching maximum advised dosage. Cyanide is a potentially lethal toxic agent that can be found in liquid and gaseous form. Found inside – Page 353Sodium nitroprusside at therapeutic doses has been shown to release cyanide in ... sulfurtransferase (rhodanase) to thiocyanate, which is less toxic (19). The usual dose rate is 0.5-10 mcg/kg/min, but infusion at the maximum dose rate should never last more than 10 minutes. Overdose may manifest as excessive hypotension or cyanide toxicity or as thiocyanate toxicity. (B) CYANIDE TOXICITY: Sodium nitroprusside metabolism produces dose-related cyanide, which can be lethal. Except when used briefly or at low ( < 2 mcg/kg/min) infusion rates, sodium nitroprusside gives rise to important quantities of cyanide ion, which can reach toxic, potentially lethal levels (seeWARNINGS). The usual dose rate is 0.5 to 10 mcg/kg/min, but infusion at the maximum dose rate should never last more than 10 minutes. The FDA requires all potential medication risks for NIPRIDE RTU (sodium nitroprusside injection, solution) be disclosed to consumers, no matter how rare. 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