amyl nitrite

[am´il ni´trīt]

a volatile, flammable liquid with a pungent ethereal odor. It is administered by inhalation for the treatment of cyanide poisoning, producing methemoglobin which binds cyanide, and as a diagnostic aid in tests of reserve cardiac function and diagnosis of certain heart murmurs. It is abused to produce euphoria or sexual stimulation.

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.

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.

am·yl ni·trite

a vasodilator used to treat angina pectoris and cyanide poisoning.

amyl nitrite

A volatile yellow liquid, C₅H₁₁NO₂, 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.

am·yl ni·trite

(ā'mil nīt'rīt)

An inhalable compound used in the United States as the first step in the antidotal treatment of cyanide poisoning.
See also: sodium nitrite, sodium thiosulfate, hydroxycobalamin

amyl nitrite

A volatile drug used by inhalation in the control of pain in ANGINA PECTORIS. It acts by relaxing smooth muscle and thus dilating arteries, including the coronary arteries. The pain is relieved because of the improved blood supply to the heart muscle.