Amyl Nitrite (redirected from Isoamyl Nitrite)

amyl nitrite

n.

A volatile yellow liquid formerly used in medicine as a vasodilator, but now replaced by other nitrates, such as nitroglycerin. It is used illicitly to induce euphoria and enhance sexual stimulation.

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amyl nitrite

Amyl Nitrite

Pharmacologic class: Coronary vasodilator

Therapeutic class: Antianginal

Pregnancy risk category C

Action

Relaxes vascular smooth muscle, thereby dilating large coronary vessels, decreasing systemic vascular resistance, reducing afterload, decreasing cardiac output, and relieving angina

Availability

Ampules: 0.3 ml

⊘Indications and dosages

➣ Acute angina attack

Adults: 0.18 to 0.3 ml by inhalation, repeated in 3 to 5 minutes if needed

➣ Antidote for cyanide poisoning

Adults and children: 0.3 ml by inhalation for 15 to 30 seconds q 5 minutes until sodium nitrite infusion is available

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• glaucoma, hypotension, hyperthyroidism, severe anemia, early myocardial infarction
• elderly patients
• pregnant or breastfeeding patients.

Administration

• Crush ampule and wave under patient's nose one to six times. If needed, repeat in 3 to 5 minutes.

Route	Onset	Peak	Duration
Inhalation	30 sec	Unknown	3-5 min

Adverse reactions

CNS: headache, dizziness, weakness, syncope, restlessness

CV: orthostatic hypotension, flushing, palpitations, tachycardia

EENT: increased intraocular pressure

GI: nausea, vomiting, fecal incontinence

GU: urinary incontinence

Hematologic: hemolytic anemia, methemoglobinemia

Skin: cutaneous vasodilation, rash, pallor, facial and neck flushing

Interactions

Drug-drug. Aspirin: increased amyl nitrite blood level and action

Calcium channel blockers: increased risk of symptomatic orthostatic hypotension

Sildenafil: increased risk of hypotension

Sympathomimetics: decreased antianginal effects, hypotension, tachycardia

Drug-behaviors. Alcohol use: severe hypotension, cardiovascular collapse

Patient monitoring

• Monitor vital signs. Stay alert for tachycardia and orthostatic hypotension.
• Assess for bowel and bladder incontinence.
• Monitor neurologic response. Watch closely for dizziness and syncope.
• Assess level of headache pain.
• In long-term therapy, monitor CBC.

Patient teaching

• Teach patient to crush capsule and wave it under his nose until angina is relieved (usually after one to six inhalations).
• Tell patient that drug often causes dizziness, orthostatic hypotension, and syncope. Advise him to sit or lie down until these effects subside.
• Inform patient that drug often causes headache. Instruct him to follow prescriber's recommendations for pain relief.
• Tell patient that drug may cause fecal or urinary incontinence. Encourage him to use bathroom frequently to avoid accidents.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.