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William H. Montgomery, MD
Straub Clinic and Hospital Honolulu

JAMA. 1986;256(13):1724-1725.

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In Reply.—

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Dr Neathawk and colleagues and Dr Tek have appropriately indicated that the dosage of sodium nitroprusside as published (10 to 20 mg/min) is much too high. The correction, published in this issue,¹ corrects the milligrams to micrograms, which was the original intent. It should now read 10 to 20 µg/min. Product prescribing information states that the dosage range is 0.5 to 10 µg/kg/min, and, assuming a 70-kg victim, the initial dose would be 35 to 700 µg/min. The standards and guidelines clearly recommend a lower initial dose; however, this is consistent with the philosophy adopted for all drug administration in the standards and guidelines. All initial dosages are purposefully on the low side to accommodate a broad range of clinical situations to avoid unnecessary morbidity and unnecessary complications in critical situations. These low initial doses . . . [Full Text PDF of this Article]

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