Lactic Acidosis Complicating Sodium Nitroprusside Therapy
Authors: Stephen H. Humphrey, Daniel A. Nash
Journal: Annals of Internal Medicine (1978)

Brief Reports1 January 1978Lactic Acidosis Complicating Sodium Nitroprusside TherapySTEPHEN H. HUMPHREY, M.D., DANIEL A. NASH JR., M.D., F.A.C.P.STEPHEN H. HUMPHREY, M.D., DANIEL A. NASH JR., M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-1-58 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSodium nitroprusside has gained acceptance in the treatment of hypertensive emergencies and low cardiac-output syndromes associated with high systemic vascular resistance. Manifestations of toxicity have included fatigue, nausea, disorientation, psychotic behavior, and muscle spasm believed attributable to the accumulated metabolite thiocyanate (1). Metabolic acidosis complicating sodium nitroprusside-induced hypotension has been encountered in isolated clinical experiences (2) as well as an animal study (3). We describe a case in which sodium nitroprusside therapy of uncontrolled hypertension was complicated by the development of lactic acidosis, without hypotension.A 66-year-old woman was admitted because of severe hypertension. Additional medical problems included adult-onset diabetes...References1. PALMER R and LASSETER K: Drug therapy: sodium nitroprusside. N Engl J Med 292:294-297, 1975 CrossrefMedlineGoogle Scholar2. GREISS L, TREMBLAY N, and DAVIES D: The toxicity of sodium nitroprusside. Can Anaesth Soc J 23:480-485, 1976 CrossrefMedlineGoogle Scholar3. MCDOWALL D, KEANEY N, TURNER J, LANE J, and OKUDA Y: The toxicity of sodium nitroprusside. Br J Anaesth 46:327-332, 1974 CrossrefMedlineGoogle Scholar4. SMITH R and KRUSZYNA H: Toxicology of some inorganic antihypertensive anions. Fed Proc 35:69-72, 1976 MedlineGoogle Scholar5. VESEY C, COLE P, and SIMPSON P: Cyanide and thiocyanate concentrations following sodium nitroprusside infusion in man. Br J Anaesth 48:651-660, 1976 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: STEPHEN H. HUMPHREY, M.D.; DANIEL A. NASHJR., M.D., F.A.C.P. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMedication‐Induced Hyperlactatemia and Lactic Acidosis: A Systematic Review of the LiteratureSodium NitroprussideChronic cyanide exposureSodium nitroprussideSodium NitroprussideRapidly Progressive Lactic Acidosis in Patients with Flufenoxuron PoisoningClinical Syndromes of Metabolic AcidosisAcid-Base Disorders Secondary to PoisoningClinical Syndromes of Metabolic AcidosisLactic Acidosis: From Sour Milk to Septic ShockA Simple, Rapid and Sensitive Semimicro Method for the Measurement of Cyanide in BloodTherapy of Lactic AcidosisNatural history and course of acquired lactic acidosis in adultsLactic AcidosisCyanide Toxicity from Sodium Nitroprusside: Risks and ManagementHypertensive EmergenciesNitroprusside, Nitroglycerin, and Angiotensin-Converting Enzyme InhibitorsLactic acidosisHypertensive CrisisSerum electrolyte abnormalities caused by drugsVasoactive Drugs and the Failing VentricleCyanide toxicity of sodium nitroprusside in therapeutic use with and without sodium thiosulphateKlinische PharmakologieHypotensive drugs 1 January 1978Volume 88, Issue 1Page: 58-59KeywordsHypertensionHypotensionLactic acidosisMetabolitesMusclesNauseaSodiumSystemic vascular resistanceToxicityType 2 diabetes ePublished: 1 December 2008 Issue Published: 1 January 1978 PDF downloadLoading ...