<p>Sodium nitroprusside should not be used in the treatment of compensatory hypertension, where the primary hemodynamic lesion is&nbsp;aortic&nbsp;coarctationor arteriovenous shunting.<br />
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Sodium nitroprusside should not be used to produce hypotension during surgery in patients with known inadequate cerebral circulation, or in moribund patients (A.S.A. Class 5E) coming to emergency surgery.<br />
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Patients with congenital (Leber&#39;s) optic atrophy or with tobacco amblyopia have unusually high cyanide/thiocyanate ratios. These rare conditions are probably associated with defective or absent rhodanase, and sodium nitroprusside should be avoided in these patients.<br />
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Sodium nitroprusside should not be used for the treatment of acute&nbsp;congestive heart failure&nbsp;associated with reduced peripheral vascular resistance such as high-output&nbsp;heart failure&nbsp;that may be seen in endotoxic sepsis.</p>