[Toxicity of sodium nitroprusside (author's transl)]

The mode of breakdown of sodium nitroprusside (NPN) is described and the fact is pointed out that cyanide is formed during the process. The main mode of detoxication leads to the production of thiocyanate. Potential effects of cyanide formation are: blocking of cytochrome oxidase and carbonic anhydrase and cyanmethaemoglobin. The clinical features of NPN poisoning are reviewed. The importance of preventing NPN poisoning by strictly adhering to the maximun doses (1.5mg/kg bodyweight) is emphasized. Anti-dose are; injections of hydroxycobalamin (22.4 mg/mg NPN) and sodium thiosulfate (5.0 mg/mg NPN). The use of drugs to induce methaemoglobin formation is now obsolete. As only very few cases of NPN poisoning have so far been reported; there is no need to discontinue the use of this drug, provided the maximun dosis is not exceeded and the patient is under strict surveillance.