Amyl Nitrite

Name: Amyl Nitrite

Pharmacology

Mechanism of Action

Vasodilating agent

Relaxes smooth muscle via dose-dependent dilation of arterial and venous beds to reduce both preload and afterload, and myocardial O2 demand

Also improve coronary collateral circulation. Lower BP, incr HR, occasional paradoxical bradycardia

Cyanide Poisoning: Nitrite ions react with hemoglobin to form methemoglobin which unites with cyanide to form cyanomethemoglobin; this causes cytochrome oxidase to become free, which in turn allows aerobic metabolism to continue

Pharmacokinetics

Onset: 10-30 sec

Duration: 3-15 min (angina)

Peak: 3 min

Description

Amyl nitrite (amyl nitrite inhalant) is a rapidly acting vasodilator administered by inhalation. 0.3mL is supplied in a covered thin glass capsule which is easily crushed between the fingers. Amyl nitrite (amyl nitrite inhalant) is a clear, yellowish liquid having a peculiar ethereal, fruity odor. It is volatile, even at low temperatures, and is flammable. This product is stabilized with Flexol ™ 2 %. The structural formula of amyl nitrite is: (CH3)2CHCH2CH2ONO

Indications

Amyl nitrite (amyl nitrite inhalant) is indicated for the rapid relief of angina pectoris. Its effect appears within 30 seconds and lasts for approximately 3 to 5 minutes.

Warnings

Transient episodes of dizziness, weakness, or syncope or other signs of cerebral ischemia due to postural hypotension may develop following inhalation of amyl nitrite, particularly if the patient is standing immobile. To hasten recovery, measures which facilitate venous return such as head-low posture, deep breathing and movement of extremities may be used.

CAUTION: Amyl Nitrite (amyl nitrite inhalant) is very flammable. Do not use where it might become ignited.

Overdose

Symptoms

Inhaled doses of 5 to 10 drops of amyl nitrite (amyl nitrite inhalant) may cause violent flushing of the face, accompanied by a feeling of imminent bursting of the head and very excessive heart action. The inhalation of larger amounts may produce a feeling of suffocation and muscular weakness. Symptoms comparable to shock may be produced (such as weakness, restlessness, sweating, pallor, nausea, vomiting, syncope and incontinence) attributable to pooling of blood in the post arteriolar vessels and failure of the venous blood to return to the heart.

Treatment

Measures which facilitate venous return such as head-low posture, deep breathing and movement of extremities may be used. The use of epinephrine aggravates the shocklike reaction. Methylene blue should be injected for treatment of severe methemoglobinemia with dyspnea. For treating cyanide poisoning, methylene blue is contraindicated where nitrites cause iatrogenic methemoglobinemia.

Amyl Nitrite Interactions

This is not a complete list of Amyl Nitritedrug interactions. Ask your doctor or pharmacist for more information.

How do I store and/or throw out Amyl Nitrite?

  • Store in a refrigerator. Do not freeze.
  • Protect from light.
  • Protect from heat or open flame.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

Amyl nitrite Pregnancy Warnings

Amyl nitrite has been assigned to pregnancy category C by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Amyl nitrite should only be given to a pregnant woman if clearly needed.

Amyl nitrite can cause harm to the fetus when it is administered to a pregnant woman because it significantly reduces systemic blood pressure and blood flow on the maternal side of the placenta.

Amyl nitrite Breastfeeding Warnings

There are no data on the excretion of amyl nitrite into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

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