What adverse effect is a concern with the use of nitroprusside?

Cyanide toxicity is a significant concern with the use of nitroprusside due to its chemical composition. Nitroprusside is metabolized in the body to release cyanide, which can lead to toxic effects, especially in conditions where there is inadequate renal function or prolonged infusion of the drug. In situations where nitroprusside is administered for an extended period or at high doses, the accumulation of cyanide can become lethal, presenting with symptoms such as confusion, metabolic acidosis, and respiratory distress.

Proper monitoring and dosage are crucial when using nitroprusside to avoid the risk of cyanide toxicity. Healthcare providers often take precautions, including measuring blood cyanide levels and using alternative agent if toxicity is suspected or if the duration of therapy is likely to be lengthy.