Amyl Nitrate

Question 1

Drug Classification

Answer 1

Antidote/Nitrate Vasodilator

Question 2

Mechanism of Action

Answer 2

Short acting vasodilator and SMC relaxant that oxidases hemoglobin to become methemoglobin, which forms a non-toxic complex with the cyanide ion to form cyanomethemoglobin, which can be enzymatically degraded

Question 3

Pharmacokinetics

Answer 3

• Onset of Action- 10-30 seconds
• Peak Effects- 30 seconds
• Duration of Effects- 3-5 minutes
• Half-Life- N/A

Question 4

Indications/Field Use

Answer 4

Cyanide Poisoning

Question 5

Contraindications

Answer 5

None

Question 6

Side Effects/Adverse Reaction

Answer 6

Headache/Dizziness/Weakness/Flushing

Coldsweats/tachycardia/syncope/orthostatic hypotension/ N&V

Question 7

Dose

Answer 7

Adult:
0.3mL ampule crushed, inhaled over 15-30 seconds q 1min until sodium nitrate infusion is available

Pedi:
0.3mL ampule crushed, inhaled over 15-30 seconds q 1min until sodium nitrate infusion is available

Question 8

Precautions

Answer 8

• May be a medication of abuse, should be stored in a place with narcotics
• Smells like dirty, sweaty socks
• Ensure patient is sitting prior to administration, hypotension and syncope maybe sudden

Question 9

Drug-Drug Interactions

Answer 9

Hypotension is potentiated by anti-hypertensives, beta blockers, and certain anti-emetics (phenothiazines)