Toxic effects of drugs used in the ICU. Nitroprusside, nitroglycerin, and angiotensin-converting enzyme inhibitors.
Sodium nitroprusside causes cyanide poisoning at currently recommended infusion rates. Serum thiocyanate concentrations are of no value in detecting cyanide poisoning caused by nitroprusside. Methemoglobinemia in those patients receiving intravenous nitroglycerin may seriously impair oxygen delivery and is not always accompanied by cyanosis in anemic patients. Angiotensin-converting enzyme inhibitors are responsible for a plethora of adverse effects, including renal insufficiency, hypotension, angioedema, cough, and increased insulin sensitivity.
Curry
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Good Samaritan Regional Medical Center, Phoenix Children's Hospital, Arizona.
Arnold-Capell
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D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D003422:Critical Care; D003486:Cyanides / Q000506:poisoning; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008708:Methemoglobinemia / Q000139:chemically induced; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects*; D009599:Nitroprusside / Q000009:adverse effects* / Q000627:therapeutic use; D013861:Thiocyanates / Q000506:poisoning
D000806:Angiotensin-Converting Enzyme Inhibitors; D003486:Cyanides; D013861:Thiocyanates; D009599:Nitroprusside; D005996:Nitroglycerin; C031760:thiocyanate