Amylnitrite

When ATH:
V03AB22

Characteristic.

Transparent yellowish thin liquid with a high degree of volatility (It evaporates even at low temperature) and a characteristic fruity odor (pear essences). Highly flammable. Very slightly soluble in water; miscible in all proportions with alcohol, ether, xloroformom. The density of 0,869-0,879.

Pharmacological action.
Antianginalnoe, vasodilator, antidote otravlenii tsianidami.

Application.

Relief of angina attacks (in exceptional cases, in the absence of other antianginal drugs); hydrogen sulfide poisoning, hydrocyanic acid and its salts (цianidami); auxiliary diagnostic tool in the study of the function of the heart to assess its reserve possibilities.

Contraindications.

Hypersensitivity, incl. Nitrate, anemia, bleeding in the brain, increased intracranial pressure, a recent head injury, severe hypotension, zakrыtougolynaya glaucoma (high intraocular pressure), hyperthyroidism, recent myocardial infarction, pregnancy, lactation, childhood (to 5 years).

Pregnancy and breast-feeding.

Research was conducted. It should be taken into account, There is a risk that the reduction in blood flow to the placenta due to systemic hypotension.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding (no data on the penetration of breast milk, However, it should consider the possibility of serious adverse effects in infants).

Side effects.

From the nervous system and sensory organs: transient headache, dizziness, restlessness, weakness, fainting, paleness, cold sweat.

Cardio-vascular system and blood (hematopoiesis, hemostasis): rush of blood to the face and neck, gipotenziya, incl. orthostatic, tachycardia, metgemoglobinemiâ (long-term use in high doses).

From the digestive tract: nausea, vomiting.

Other: involuntary urination and defecation, gemoliticheskaya anemia (unusual tiredness or weakness), skin rash.

Cooperation.

Alcohol may exacerbate the side effects, particularly cardiovascular (may develop severe hypotension up to collapse). In an application with drugs, causes a decrease in blood pressure, may increase the hypotensive effects of orthostatic.

Overdose.

Symptoms: at doses of 5-10 drops - severe facial flushing, severe headache, accompanied by a feeling of "splitting" the head, sharp tachycardia; in doses more 10 drops - the feeling of suffocation, muscular weakness, nausea, vomiting, blanching, increased perspiration, anxiety, drop in blood pressure, fainting, and other symptoms of cardiovascular and respiratory failure.

Treatment: when methemoglobinemia with severe shortness of breath - oxygen, blood transfusion, in / in a specific antidote - 1% methylthioninium chloride solution (Methylene blue) dose 0,001 g / kg (but not in the case of amyl nitrite for treating cyanide toxicity); it is also necessary to lower the head end of the bed and ask the patient to breathe as deeply as possible, as well as flexion and extension of limbs.

Dosing and Administration.

Inhalation; in the supine position, leaning or sitting; applied to a handkerchief or small piece of cotton, Gauze et al. and inhale. For relief of angina attack - adults 2-3 drops, older children 5 years - 1-2 drops; if required repeated inhalation 3-5 minutes. Higher doses for adults: single - 6 drops (0,1 ml), daily - 30 drops (0,5 ml). When cyanide poisoning - again to a total dose of 0.5-1 ml.

Precautions.

To use caution in patients with a deficiency of methemoglobin reductase and other violations of the transition of methemoglobin in the hemoglobin, on the background of alcohol. To reduce the likelihood of developing tolerance, you need to start with the lowest effective dose. Medical staff and others, serving the sick, Avoid breathing vapors. To prevent side effects in patients, systematically taking amyl nitrite, recommended periodic monitoring of blood pressure and heart activity monitoring. Caution should be used in elderly patients due to the increased risk of orthostatic hypotension. Avoid drinking alcohol, and be careful while appointing with antihypertensive drugs. In cases of overdose, if necessary, the use of vasoconstrictor epinephrine should be avoided.

Cautions.

It is necessary to take into account, that opening vials accompanied by a slight explosion (in connection with a vapor pressure, formed during storage); pairs form explosive mixtures with air. Protect from light and heat (Keep away from fire).