What complication can occur from Sodium Nitroprusside in patients with renal or liver dysfunction?

Sodium nitroprusside is a potent vasodilator often used in critical care settings to manage severe hypertension and cardiac conditions. However, its metabolism can lead to complications, especially in patients with renal or liver dysfunction.

In these patients, the metabolism of sodium nitroprusside can be impaired, resulting in the accumulation of cyanide. The drug breaks down to cyanide ions, which can lead to cyanide toxicity when there is reduced capacity to detoxify and eliminate these byproducts. In addition to cyanide, thiocyanate, another metabolite, can accumulate, particularly with prolonged use or high doses, further increasing the risk of toxicity.

Cyanide toxicity can manifest as symptoms such as confusion, weakness, metabolic acidosis, and cardiovascular instability, which can be life-threatening if not addressed promptly. Thus, monitoring kidney and liver function is essential when administering sodium nitroprusside to prevent these complications.

The other options represent potential changes in blood pressure or heart rhythm that may occur during treatment, but they do not specifically highlight the critical risk of cyanide and thiocyanate toxicity that is uniquely associated with the pharmacokinetics of sodium nitroprusside.