Nifedipine in Hypertensive Emergencies of Children

Dilmen, Uğur; Cağlar, M; Senses, Dursun Alí; Kinik, E

doi:10.1001/archpedi.1983.02140380022007

Cited by 28 publications

(15 citation statements)

References 20 publications

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“…The first report of nifedipine use in treatment of acute hypertension was published in 1983 by Dilmen and colleagues [108], who administered 0.25-0.5 mg/kg/dose of nifedipine sublingually to 21 children with severe hypertension and found that it reduced blood pressure by approximately one-third within 30 min. Duration of effect was approximately 6 h, and reported side effects included tachycardia and flushing.…”

Section: First-generation Ccbs: Verapamil Diltiazem and Nifedipinementioning

confidence: 99%

Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension

Flynn

Pasko

2000

Pediatric Nephrology

105

104

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The calcium channel blockers (CCBs) are a diverse group of antihypertensive medications with variable pharmacokinetics and clinical effects. Although CCBs have been widely applied to the treatment of hypertensive children, data regarding the pharmacokinetics, efficacy and safety of these agents in children are extremely limited. In this review we briefly summarize the mechanism of action of CCBs and then summarize pertinent pharmacokinetic information on each of the CCBs commonly used in children, including amlodipine, diltiazem, felodipine, isradipine, intravenous nicardipine, nifedipine and verapamil. Clinically important drug interactions and adverse effects are discussed, as well as the potential role of CCBs in renal protection. Available pediatric efficacy and safety data are summarized, and recommendations made regarding the rational use of CCBs in the management of pediatric hypertension.

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Section: First-generation Ccbs: Verapamil Diltiazem and Nifedipinementioning

confidence: 99%

Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension

Flynn

Pasko

2000

Pediatric Nephrology

105

104

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“…The most common mode of administration of SA nifedipine was via the sublingual route (55.6%). In children, sublingual administration is rapid, easy to administer, and effective [18,21,22,26,27,28]. However, there are adult data to suggest that the oral route has improved absorption with a less-rapid decline in blood pressure compared with the sublingual route [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are adult data to suggest that the oral route has improved absorption with a less-rapid decline in blood pressure compared with the sublingual route [24,25]. The mean dosage utilized for hypertension treatment in children in this study follows the recommended dosages of 0.2-0.5 mg/kg per dose [18,21,22,26,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…An episode of hypertension was defined as hypertension or a hypertensive crisis requiring treatment with SA nifedipine from the time of its administration to 6 h post dose. The time of 6 h was derived from pediatric clinical studies of SA nifedipine [18,21,22]. Each episode could have more than one administration of SA nifedipine if the hypertension did not resolve with the first dose.…”

Section: Definitionsmentioning

confidence: 99%

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The safety and use of short-acting nifedipine in hospitalized hypertensive children

Yiu

Orrbine

Rosychuk

et al. 2004

Pediatric Nephrology

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Recent reports suggest that calcium channel blockers are harmful in the treatment of acute hypertension in adults. However, short-acting nifedipine is an effective and useful medication in pediatric hypertension and is currently utilized for hypertensive emergencies. This study will address these safety concerns in hypertensive children. Medical records (from five Canadian pediatric hospitals) of all pediatric hypertensive hospitalized children who were treated with short-acting nifedipine from January 1995 to December 1998 were retrospectively reviewed for patient demographics, dosing regimen, use of concomitant medications, co-morbid conditions, and presence/absence of minor and serious adverse events. Final data were extracted from 182 patients. Each patient had an average of 2.6 episodes of hypertension in hospital that required treatment, totaling 477 episodes. Within the 477 episodes, 1,162 doses of short-acting nifedipine were administered. The mean dose was 0.22 mg/kg (range 0.043-0.67 mg/kg, median 0.19 mg/kg) with 55.6% (260/468 episodes) receiving the drug via the sublingual route. Hypertension resolved in 85.5% (408/477) of the episodes. There were only 29 of 574 (5.1%) minor adverse events that were definitely or probably related to short-acting nifedipine administration. Two patients experienced a serious adverse event that involved of a reduction in blood pressure of more than 40%, but neither had any symptomatology from the serious adverse event and recovered spontaneously within 2 h. Short-acting nifedipine in hypertensive, hospitalized children appears to be a safe and efficacious medication with minimal side effects.

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“…Limited trials in hypertensive children also demonstrated effective reduction of blood pressure after a single 0.25-to 0.5 mg/kg sublingual dose. 16 Purported advantages of nifedipine for the acute management of markedly elevated blood pressure include low incidence of hypotension, efficacy in patients with renal failure and refractoriness to other antihypertensive agents, lack of venous dilatation and orthostasis, no reduction in cerebral blood flow, and compatibility with other antihyper¬ tensive drugs. Both verapamil and diltiazem hydrochloride have also been shown to reduce elevated blood pres¬ sure, but the clinical experience is less than with nifedipine.17 Unfortunately, verapamil may have a negative inotropic effect at the doses that are required to affect blood pressure.…”

Section: Cardiovascular Effectsmentioning

confidence: 99%

Therapeutic Uses of Calcium Channel-Blocking Drugs in the Young

Cho¹

1986

Arch Pediatr Adolesc Med

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Nifedipine in Hypertensive Emergencies of Children

Cited by 28 publications

References 20 publications

Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension

Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension

The safety and use of short-acting nifedipine in hospitalized hypertensive children

Therapeutic Uses of Calcium Channel-Blocking Drugs in the Young

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