0
July 1986, Vol 146, No. 7 >
ARTICLE | July 1986

Sodium Nitroprusside Treatment in Patients With Acute Strokes-Reply

Patrick Lavin, MB, BCh
Arch Intern Med. 1986;146(7):1454. doi:10.1001/archinte.1986.00360190246046.
Text Size: A A A
Published online
Article
References
Comments

—Dr Garner makes three valid points that I will deal with in turn.

  1. Sodium nitroprusside is not ideal, but should be the agent of choice because it is a powerful and predictably effective agent, without a direct effect on the central nervous system, and does not cause patchy ischemia.1 It is currently favored by most experts in the field.2-5 Its capacity to cause raised intracranial pressure is not clearly established.6,7 Diazoxide, used in small frequent boluses, and α-blockers, are also effective agents. However, newer agents such as captopril8 and the calcium channel blockers9 may prove more ideal.

  2. The point that hydralazine hydrochloride caused neurologic deterioration as a result of raised intracranial pressure is well taken, however, the patient did not exhibit signs of raised

  1. intracranial pressure; the computed tomographic scan showed no mass effect, and the neurologic deficit improved on raising the blood pressure. Trimethaphan camsylate, a good drug but

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs

More Listings at
JAMACareerCenter.com >

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems