Outline the pharmacology of sodium nitroprusside (50% of marks). Discuss the  mechanisms of toxicity and their management (50% of marks).

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College Answer

Most candidates presented a structured answer and exhibited a good understanding of the 
pharmacology of sodium nitroprusside. Few candidates demonstrated an understanding of 
the mechanisms of SNP toxicity and details on management of cyanide toxicity were lacking. 
Cobalt EDTA is no-longer recommended as initial therapy in the management for cyanide 
toxicity. 
More specific detail was expected beyond a generic comment on "mechanisims of toxicity" 
such as potentially causes of respiratory, renal, hepatic or CNS failure. 
Few candidates mentioned adverse effects other than that of cyanide toxicity. Many
candidates also failed to outline the management of sodium nitroprusside toxicity