Vomiting sodium nitroprusside

Sodium nitroprusside 0.25-10 mcg/kg/minute as IV infusion11 Immediate 1-2 minutes Nausea, vomiting, muscle twitching, sweating, thiocyanate and cyanide intoxication Most hypertensive emergencies use with caution with high intracranial pressure or azotemia... 

The most commonly encountered side effects of sodium nitroprusside administration are nausea, vomiting, and headache, which quickly dissipate when the infusion is terminated. When sodium nitroprusside treatment extends for several days, there is some danger of toxicity owing to the accumulation of its thiocyanate metabolite. Thiocyanate intoxication includes signs of delirium and psychosis hypothyroidism also may occur. If nitroprusside is administered for several days, thiocyanate levels should be monitored. 

A 21-year-old Canadian man presented with severe headache, nausea and vomiting, hypertension (220/ 120 mmHg), and a sinus tachycardia of about 120/minute with frequent multifocal ventricular extra beats. He was treated with intravenous sodium nitroprusside and lidocaine and recovered fully within 24 hours. 

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