amyl nitrite


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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

n.
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.

amyl nitrite

a vasodilator.
indication It is prescribed to relieve the angiospasm of angina pectoris and as an adjunct in the treatment of cyanide poisoning.
contraindication Known hypersensitivity to this drug or to other nitrites prohibits its use, as does head injury and narrow-angle glaucoma.
adverse effects Among the serious adverse reactions are hypotension, allergic reactions, nausea, headache, and dizziness.

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.
References in periodicals archive ?
Methylene blue: A treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite.
The amyl nitrite, supplied in a simple nasal delivery system, could easily be used to treat numerous victims by simple nasal instillation, and is very well suited even for self administration.
The effects of amyl nitrite, sodium nitrite, and sodium thiosulfate (the contents of the Cyanide Antidote Package) on human pregnancy also are unknown, as are the effects of high-dose hydroxocobalamin (cyanide).
5] deficiency, M Hb, unstable Hb Drug/chemical induced Acetaminophen, amyl nitrite, benzocaine, dapsone, nitroglycerin, nitroprusside, phenazopyridine (pyridium), sulfanilamide, aniline dyes, chlorates, nitrofurans, sulfones Diet induced Nitrites, nitrates (a) Adapted from Mansouri and Lurie (1993).
Laughing gas and amyl nitrite ("poppers") can also be abused, as can hairspray and other aerosols.
As recreational drug use continues to skyrocket, one of Watt's organization's current efforts is to raise awareness among gay men about the risk of mixing Viagra and amyl nitrite ("poppers"), which led to the deaths of three gay men in West Hollywood, Calif.
MHG can be induced by environmental contact with a number of substances including nitrates/nitrites in drinking water, inhalation of gaseous nitrites such as amyl nitrite and butyl/isobutyl nitrite, and ingestion or exposure to drugs, environmental toxins, and/or industrial by-products such as nitrobenzene, anilines, and copper sulfates (11,13-15).