Adverse effects of sublingual nifedipine in acute myocardial infarction

Shettigar, U. R.; Loungani, Ramesh R.

doi:10.1097/00003246-198902000-00020

Cited by 11 publications

(3 citation statements)

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“…Numerous case reports related to the use of nifedipine describe cardiovascular adverse events such as severe hypotension, acute myocardial ischaemia or infarction, conduction disturbances, torsade de pointes, ventricular fibrillation faetal distress and death in the literature (7–18).…”

Section: Discussionmentioning

confidence: 99%

Adverse events associated with aggressive treatment of increased blood pressure

Yanturali

Akay

Ayrık

et al. 2004

International Journal of Clinical Practice

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Patients with severely increased blood pressure often present to the emergency department. Rapid lowering of blood pressure can precipitate or worsen end organ damage. We report two cases that developed cerebrovascular and cardiovascular adverse events associated with aggressive treatment of increased blood pressure by the use of sublingual nifedipine capsule. The first patient had developed ischaemic stroke; the second patient actually had acute left ventricular failure causing deteriorated, and required positive inotropic treatment for persistent hypotension. These cases emphasise that the pseudoemergency may rapidly progress into a real emergency when blood pressure is rapidly and aggressively reduced.

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Section: Discussionmentioning

confidence: 99%

Adverse events associated with aggressive treatment of increased blood pressure

Yanturali

Akay

Ayrık

et al. 2004

International Journal of Clinical Practice

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“…However, the proposal by Grossman et al for a moratorium on short-acting nifedipine is based on case reports of only 15 adult patients and 1 fetus. They describe case reports reviewed in the literature, which include: stroke, loss of consciousness, conduction disturbances, dizziness, syncope, myocardial infarction, fetal distress and death [12,13,14,15,16,17,18,19,20]. The flaw in this study is the lack of a denominator, which makes it impossible to interpret the frequency of these events [25].…”

Section: Discussionmentioning

confidence: 99%

“…Concerns regarding the safety of short-acting nifedipine emerged in 1995, with the report of an increased risk of myocardial infarction in adult patients receiving shortacting calcium channel blockers [11]. Cerebrovascular ischemia, stroke, severe hypotension, syncope, conduction disturbances and death have also been reported with nifedipine in adults [11,12,13,14,15,16,17,18,19,20]. Given the serious nature of these events, some authors propose avoiding the use of short-acting nifedipine [12,21].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the safety of short-acting nifedipine in children with hypertension

Egger

Deming

Hamada

et al. 2002

Pediatric Nephrology

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Concerns regarding the safety of nifedipine emerged in 1995 with the report of an increased risk of myocardial infarction associated with adult patients receiving short-acting calcium channel blockers. There have been few case reports of adverse events in children. The purpose of this study is to investigate the effect on blood pressure (BP) and the incidence of adverse events associated with nifedipine in our pediatric population. We conducted a retrospective chart review of pediatric patients who received nifedipine. We recorded the dose administered, all BP measurements and all adverse events reported within six hours of a nifedipine dose regardless of the likelihood that those events were related to the nifedipine dose. 1,746 doses of nifedipine in 166 pediatric patients were reviewed. Systolic BP decreased by a mean of 17% and a maximum of 63%. Diastolic BP decreased by a mean of 28% and a maximum of 89%. Adverse events included: a) change in neurologic status, six cases; b) hypotension, two cases; c) oxygen desaturation, 16 cases. Neurologic events occurred in 33% of patients with acute CNS injury and 3.6% of all patients. Short-acting nifedipine is an important and effective oral antihypertensive agent which can be safely used for the treatment of hypertensive emergencies in children. It should be used with caution in children with acute CNS injury.

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