Acute treatment of hypertensive crisis with nifedipine.

Huysmans, F. T. M.; Sluiter, Henk E.; Thien, Th.; Koene, R. A. P.

doi:10.1111/j.1365-2125.1983.tb02250.x

Cited by 48 publications

(6 citation statements)

References 8 publications

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“…Nifedipine has been widely used via oral or sublingual administration in the management of hypertensive emergencies, severe hypertension associated with chronic renal failure, perioperative hypertension, and pregnancy induced hypertension [72,129-136]. Although nifedipine has been given via the sublingual route, the drug is poorly soluble and is not absorbed through the buccal mucosa.…”

Section: Pharmacologic Agents Used In the Treatment Of Hypertensive Cmentioning

confidence: 99%

“…This mode of administration has not been approved by the US Food and Drug Administration. A significant decrease in blood pressure is usually observed 5–10 min after nifedipine administration, with a peak effect at between 30 and 60 min and a duration of action of approximately 6–8 hours [129]. …”

Section: Pharmacologic Agents Used In the Treatment Of Hypertensive Cmentioning

confidence: 99%

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2003

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Hypertension is an extremely common clinical problem, affecting approximately 50 million people in the USA and approximately 1 billion individuals worldwide. Approximately 1% of these patients will develop acute elevations in blood pressure at some point in their lifetime. A number of terms have been applied to severe hypertension, including hypertensive crises, emergencies, and urgencies. By definition, acute elevations in blood pressure that are associated with end-organ damage are called hypertensive crises. Immediate reduction in blood pressure is required only in patients with acute endorgan damage. This article reviews current concepts, and common misconceptions and pitfalls in the diagnosis and management of patients with acutely elevated blood pressure.

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Section: Pharmacologic Agents Used In the Treatment Of Hypertensive Cmentioning

confidence: 99%

Section: Pharmacologic Agents Used In the Treatment Of Hypertensive Cmentioning

confidence: 99%

Untitled

2003

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“…It is well-known that sublingual nifedipine is highly effective in the treatment of hyper tensive crisis (1)(2)(3). However, the decrease of blood pressure following nifedipine is fre quently associated with a reflex tachycardia and flushing.…”

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confidence: 99%

Comparison of sublingual captopril and sublingual nifedipine in hypertensive emergencies.

Ceyhan¹,

Karaaslan²,

Caymaz³

et al. 1990

Jpn.J.Pharmacol

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Abstract-Hypertensive crises require immediate therapy, usually by parenteral drug administration.Sublingual nifedipine has been shown to be highly effective. However, the blood pressure fall following nifedipine is frequently associated with side effects.The use of sublingual captopril has recently been indicated in hyper tensive crisis, assuming that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure than with the oral route. To verify this hypothesis, we have compared the hypotensive effects of sublingual nifedipine and sublingual captopril in 52 patients with hypertensive emergencies:25-mg captopril and 1 0-mg nifedipine were administered sublingually to 28 and 24 patients, respec tively. Blood pressures and heart rates were continuously measured up to 240 min postdose.A significant (P<0.001) hypotensive effect of both sublingual captopril and nifedipine therapy occured at 5 min and persisted for 240 min. Heart rates increased with nifedipine, but decreased with captopril.

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“…Although it is not absorbed through the buccal mucosa, it is rapidly absorbed through the gastrointestinal tract after the capsule is dissolved and causes direct arteriole vasodilation (94). A rapid and significant decrease in blood pressure occurs within 5–10 minutes, peaks at 30–60 minutes, and lasts up to 6 hours (95). As effective as nifedipine is at vasodilation, sudden and dramatic declines in blood pressure may precipitate cerebral, renal, and cardiac ischemic events that have been associated with fatal outcomes (84,94,95).…”

mentioning

confidence: 99%

“…A rapid and significant decrease in blood pressure occurs within 5–10 minutes, peaks at 30–60 minutes, and lasts up to 6 hours (95). As effective as nifedipine is at vasodilation, sudden and dramatic declines in blood pressure may precipitate cerebral, renal, and cardiac ischemic events that have been associated with fatal outcomes (84,94,95). Because of the difficulty in controlling the response to nifedipine, this drug should not be used for blood pressure control in hypertensive emergencies.…”

mentioning

confidence: 99%

CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: Current Diagnosis and Management of Hypertensive Emergency

Haas

Marik

2006

Seminars in Dialysis

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The appropriate and timely evaluation and treatment of patients with severely elevated blood pressure is essential to avoid serious adverse outcomes. Most importantly, the distinction between a hypertensive emergency (crisis) and urgency needs to be made. A sudden elevation in systolic (SBP) and/or diastolic blood pressure (DBP) that is associated with acute end organ damage (cardiovascular, cerebrovascular, or renal) is defined as a hypertensive crisis or emergency. In contrast, acute elevation in SBP and/or DBP not associated with evidence of end organ damage is defined as hypertensive urgency. In patients with a hypertensive emergency, blood pressure control should be attained as expeditiously as possible with parenteral medications to prevent ongoing and potentially permanent end organ damage. In contrast, with hypertensive urgency, blood pressure control can be achieved with the use of oral medications within 24-48 hours. This paper reviews the management of hypertensive emergencies.

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Acute treatment of hypertensive crisis with nifedipine.

Cited by 48 publications

References 8 publications

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Comparison of sublingual captopril and sublingual nifedipine in hypertensive emergencies.

CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: Current Diagnosis and Management of Hypertensive Emergency

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