Yes

Antidote; Vasodilator

Coronary vasodilator in angina pectoris; adjunct in treatment of cyanide poisoning; produce changes in the intensity of heart murmurs

X

Hypersensitivity to nitrates; severe anemia; head injury; angle-closure glaucoma; postural hypotension; head trauma or cerebral hemorrhage; pregnancy

Use with caution in patients with increased intracranial pressure, low systolic blood pressure, and coronary artery disease.

1% to 10%:

Cardiovascular: Postural hypotension, cutaneous flushing of head, neck, and clavicular area, tachycardia

Central nervous system: Headache, restlessness

Gastrointestinal: Nausea, vomiting

<1% (Limited to important or life-threatening symptoms): Hemolytic anemia

Symptoms of overdose include hypotension

Treatment includes general supportive measures for transient hypotension; I.V. fluids; Trendelenburg position, vasopressors

Increased toxicity: Alcohol

Store in cool place; protect from light

Onset of action: Angina relieved within 30 seconds

Duration: 3-15 minutes

Nasal inhalation:

Angina: Adults: 1-6 inhalations from 1 crushed ampul; may repeat in 3-5 minutes

Monitor blood pressure during therapy

Amyl nitrate may be used during echocardiographic evaluation to elicit a gradient across the cardiovascular outflow tract in patients with underlying hypertrophic obstructive cardiomyopathy. Amyl nitrate is also used as a recreational drug during intercourse. However, when used in combination with sildenafil (Viagra®), significant and profound hypotension may result.

May cause headache

None reported

No information available to require special precautions

No effects or complications reported

When this drug is used in emergency situations, patient education should be appropriate to situation (ie, do not change positions or make any sudden moves without asking for assistance). If patient administered, lie down during administration, crush ampul in woven covering between fingers, and then hold under nose and inhale. May repeat in 3-5 minutes if necessary. If no relief after three doses, contact emergency services for transport to hospital immediately. Vapors are highly flammable; do not use where vapors may ignite. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intent to be pregnant, may cause severe fetal defects. Breast-feeding is not recommended.

Inhalant, crushable glass perles: 0.18 mL, 0.3 mL

Dudley MJ and Solomon T, "A Case of Methaemoglobinaemia," Arch Emerg Med, 1993, 10(2):117-9.

Laaban JP, Bodenan P, and Rochemaure J, "Amyl Nitrate Poppers and Methemoglobinemia," Ann Intern Med, 1985, 103(5):804-5.

Osterloh J and Olson K, "Toxicities of Alkyl Nitrites," Ann Intern Med, 1986, 104(5):727.

Schwartz RH, "When to Suspect Inhalant Abuse," Patient Care, 1989, 23:39-64.