Intravenous nicardipine for the treatment of severe hypertension

Wallin, J. D.; Cook, M. Eileen; Blanski, Lori; Bienvenu, Gregory S.; Clifton, Gil; Langford, Herbert G.; Turlapaty, Prasad; Laddu, Atul R.

doi:10.1016/0002-9343(88)90582-7

Cited by 56 publications

(4 citation statements)

References 26 publications

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“…For antihypertensive medication, nicardipine was chosen because it shows fast onset of antihypertensive action with reflex increase in heart rate [11]. We thought that reflex increase in the heart rate of nicardipine would be beneficial, since sudden bradycardia can be found during gasserian ganglion thermoablation owing to trigeminocardiac reflex.…”

Section: Discussionmentioning

confidence: 99%

Gasserian ganglion radiofrequency thermoablation in a patient with aneurysm of the anterior communicating artery

2021

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BackgroundGasserian ganglion radiofreqeucy thermoablation is a good treatment option for the management of pain in trigeminal neuralgia. We report a case in which the patient of trigeminal neuralgia combined with anterior cerebral artery aneurysm was treated successfully by gasserian ganglion thermoablation without any complication.CaseAn 85-year-old female presenting with electric shock like sensation in the gum and molar teeth was diagnosed as trigeminal neuralgia. Carbamazepine medication and trigeminal nerve blockade relieved her pain partially, but severe side effects of carbamazepine occurred. Magnetic resonance angiography of the brain showed saccular aneurysm in inferior aspect of the anterior communicating artery. Gasserian ganglion thermoablation under sedation anesthesia using nicardipine was performed carefully without any rupture of the cerebral aneurysm.ConclusionsGasserian ganglion thermoablation could be performed safely in a patient with cerebral aneurysm without any inadvertent event.

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Section: Discussionmentioning

confidence: 99%

Gasserian ganglion radiofrequency thermoablation in a patient with aneurysm of the anterior communicating artery

2021

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“…Especially, nicardipine hydrochloride injection has been widely used for emergency treatment of abnormally high blood pressure because NIC injection has a rapid onset of action after intravenous injection. Although these attractive pharmacological profiles, one of the dose-limiting factors of NIC is severe peripheral vascular injury after intravenous injection (Wallin et al, 1988). In severe cases, surgery such as debridement or skin grafting must be carried out (Yuasa et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Characterization of nicardipine hydrochloride-induced cell injury in human vascular endothelial cells

Ochi¹,

Kawai

Tanaka³

et al. 2015

J. Toxicol. Sci.

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-Nicardipine hydrochloride (NIC), a dihydropyridine calcium-channel blocking agent, has been widely used for the treatment of hypertension. Especially, nicardipine hydrochloride injection is used as first-line therapy for emergency treatment of abnormally high blood pressure. Although NIC has an attractive pharmacological profile, one of the dose-limiting factors of NIC is severe peripheral vascular injury after intravenous injection. The goal of this study was to better understand and thereby reduce NIC-mediated vascular injury. Here, we investigated the mechanism of NIC-induced vascular injury using human dermal microvascular endothelial cells (HMVECs). NIC decreased cell viability and increased percent of dead cells in a dose-dependent manner (10-30 μg/mL). Although cell membrane injury was not significant over 9 hr exposure, significant changes of cell morphology and increases in vacuoles in HMVECs were observed within 30 min of NIC exposure (30 μg/mL). Autophagosome labeling with monodansylcadaverine revealed increased autophagosomes in the NIC-treated cells, whereas caspase 3/7 activity was not increased in the NIC-treated cells (30 μg/mL). Additionally, NIC-induced reduction of cell viability was inhibited by 3-methyladenine, an inhibitor of autophagosome formation. These findings suggest that NIC causes severe peripheral venous irritation via induction of autophagic cell death and that inhibition of autophagy could contribute to the reduction of NIC-induced vascular injury.

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“…However, NIC injection causes peripheral vascular injury at the injection site (Wallin et al, 1988). In severe cases, surgery such as debridement or skin grafting must be carried out (Yuasa et al, 1997), placing increased demands on the medical staff's time and raising medical costs.…”

Section: Introductionmentioning

confidence: 99%

Protective effect of <i>N</i>-acetylcysteine against nicardipine hydrochloride-induced autophagic cell death of human vascular endothelial cells

Ochi¹,

Tanaka²,

Toyoda³

2015

J. Toxicol. Sci.

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-Nicardipine hydrochloride (NIC) injection has been widely used for emergency treatment of abnormally high blood pressure. However, NIC injection often causes severe peripheral vascular injury. The purpose of the present study was to reduce the NIC-induced cell injury in human vascular endothelial cells by use of clinical agents. The mechanism of NIC-induced cell injury was evaluated by time-lapse microscopic imaging, autophagosome staining with monodansylcadaverine, immunostaining of light chain 3 isoform B (LC-3B) and assessment of cell viability after exposure to NIC with or without an inhibitor of autophagosome formation (3-methyladenine, 3-MA). Results from autophagosome labeling and immunostaining of LC-3B revealed an increase of autophagosomes and LC-3B in NIC-treated cells. NIC-mediated reduction of cell viability was inhibited by 3-methyladenine. Moreover, we found that N-acetylcysteine (NAC) reduced NIC-induced cell injury in human vascular endothelial cells. These findings suggest that NIC causes severe peripheral venous irritation via induction of autophagic cell death and that inhibition of autophagy with NAC could contribute to the reduction of NIC-induced vascular injury.

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Intravenous nicardipine for the treatment of severe hypertension

Cited by 56 publications

References 26 publications

Gasserian ganglion radiofrequency thermoablation in a patient with aneurysm of the anterior communicating artery

Gasserian ganglion radiofrequency thermoablation in a patient with aneurysm of the anterior communicating artery

Characterization of nicardipine hydrochloride-induced cell injury in human vascular endothelial cells

Protective effect of <i>N</i>-acetylcysteine against nicardipine hydrochloride-induced autophagic cell death of human vascular endothelial cells

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