The Nitric Oxide Inhibitor
Inhibits nitric oxide synthesis for vasoplegia post-cardiac surgery and refractory septic shock. Avoid in patients on SSRIs (serotonin syndrome risk) and G6PD deficiency.
-
Mechanism: Inhibits Nitric Oxide Synthase (NOS) and Guanylate Cyclase. Stops vasodilation.
-
Dosing: Vasoplegia: 1-2 mg/kg IV over 20-60 min, may repeat. Max: 7 mg/kg total.
-
PK: Onset: Rapid. Duration: Several hours.
indications
- Vasoplegia (Post-Cardiac Surgery)
- Refractory Septic Shock (Rescue)
cautions
- Serotonin Syndrome (MAO Inhibitor property) – Avoid if on SSRIs
- G6PD Deficiency (Haemolysis)
- SpO2 can read falsely low due to the blue dye.