If the patient was started on nitroprusside and now has the following symptoms; nausea, heart failure, confusion, rapid breathing, and tachycardia it very well could be cyanide toxicity. The antidote that a pharmacist would recommend would be Sodium thiosulfate + Sodium nitrite. Hydroxocobalamin can also be used as an antidote. It is very important the 55-year-old Hispanic female is given the antidote as soon as possible due to her renal insufficiency.