The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED

Komura, Stephanie; Awad, Nadia I.

doi:10.1016/j.ajem.2016.03.050

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…An additional advantage of the drug is that it increases myocardial contractility and increases coronary sinus blood (exact mechanism is unknown). It also produces a dose-dependent decrease in blood pressure and peripheral vascular resistance with a mild increase in heart rate, cardiac output, and stroke volume, but no significant change in LV end-diastolic pressure and hence the use in CHF remains controversial 35 .…”

Section: Nicardipine: (A) Pharmacology: a First Generationmentioning

confidence: 99%

“…The drug is 95% proteins bound and undergoes rapid and extensive hepatic metabolism by CYP3A4, CYP2D6, CYP2C9, CYP2C19, and CYP2C8. It is an inhibitor of CYP3A4, CYP2D6, and CYP2C19 (hence has significant interactions with digoxin, clopidogrel, amiodarone, anti-arrhythmic, azoles, antifungal, anti-depressants, anti-tubercular drugs) 35,36 . More than 60% is excreted by renal route with t 1/2 of about 10 h, which increases in liver disease hence requiring dose adjustments 36 .…”

Section: B Pharmacokineticsmentioning

confidence: 99%

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2019

IJPSR

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The calcium channel blockers, a diverse group of cardiovascular drugs, exert their action by inhibiting the L-type calcium channels and cause vasodilatation in the heart and the smooth muscles. They also block the action potential at the SA and AV node, thus prolonging the duration of the action potential (Verapamil and Diltiazem). Although, the calcium channel blockers have the same anti-hypertensive actions, they have a vast difference in their pharmacological actions, pharmacokinetic profile, and adverse reactions. The main aim was to review, compare, and understand the complete pharmacological profile of all the calcium channel blockers and understand their place in pharmacotherapy. Numerous articles and studies showed that amlodipine remains to be the safe and effective drug of choice in chronic hypertension due to its slow, prolonged duration of action and lesser incidence of reflux tachycardia. The newer calcium channel blockers, although similar to amlodipine in blood pressure lowering effect, have several pharmacological advantages. Felodipine was found to be slightly better than amlodipine in the treatment of ischemia/angina due to its high pre-load reducing the effect. Lercanidipine was found to be a better reno-protective agent than amlodipine due to its actions in the kidney. Benidipine was found to be an excellent, antiatherosclerotic, and reno-protective agent. The incidence of baroreceptor activation and pedal edema was also found to be lower in the newer calcium channel blockers. Hence, the new generation calcium channel blockers could be preferred for various cardiovascular problems. 2. General Pharmacology: A high cytosolic calcium concentration causes increased contraction of the heart and the vascular smooth muscles 3. Calcium generally enters the cell via the slow Ltype calcium channels from the extracellular fluid into the cytosol, which causes an increased release of calcium from the sarcoplasmic reticulum and

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Section: Nicardipine: (A) Pharmacology: a First Generationmentioning

confidence: 99%

Section: B Pharmacokineticsmentioning

confidence: 99%

Untitled

2019

IJPSR

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“…an intravenous medication is effective and safe in these situations. 32 The recommended initial infusion rate of nicardipine is 5 mg/h, which may be increased every 5 minutes by 2.5 mg/h, up to a maximum of 15 mg/h until the chosen BP reduction is attained. There is no required dose modification in case of elderly patients, and there is no dependence on the patient's weight.…”

Section: Intravenous Antihypertensive Medication In Hypertensive Emermentioning

confidence: 99%

An Updated Review of Hypertensive Emergencies and Urgencies

Makó

Ureche

Jeremiás

2018

Journal of Cardiovascular Emergencies

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A hypertensive crisis is an abrupt and severe rise in the arterial blood pressure (BP) occurring either in patients with known essential or secondary hypertension, or it may develop spontaneously. The most frequent cause for the severe and sudden increase in BP is inadequate dosing or stopping antihypertensive treatment in hypertensive patients. Severe hypertension can be defined as either a hypertensive emergency or an urgency, depending on the existence of organ damage. In hypertensive urgencies, there are no signs of acute end-organ damage, and orally administered drugs might be sufficient. In hypertensive emergencies, signs of acute end-organ damage are present, and in these cases, quickly-acting parenteral drugs must be used. The prompt recognition, assessment, and treatment of hypertensive urgencies and emergencies can decrease target organ damage and mortality. In this review, the definitions and therapeutic recommendations in a hypertensive crisis are presented in the light of the 2017 ACC/AHA Hypertension Guidelines.

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“…However, the optimal method of administration of antihypertensive drugs during the hyperacute phase after ICH is still not established [ 18 ]. To date, one case report demonstrated the excellent effect of nicardipine bolus in reducing BP, which was given to a patient with a large ICH and intraventricular hemorrhage (IVH) [ 19 ]. Another cohort study collected data from patients with ICH who received three different antihypertensive agent boluses including nicardipine without mentioning details of drugs administration [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial: Comparing blood pressure reduction in hyperacute phase of spontaneous intracerebral hemorrhage by continuous nicardipine infusion with or without a preceding nicardipine bolus dose

Nithimathachoke,

Tiensawang,

Deechot

et al. 2023

Heliyon

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The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED

Cited by 3 publications

References 19 publications

Untitled

Untitled

An Updated Review of Hypertensive Emergencies and Urgencies

A randomized controlled trial: Comparing blood pressure reduction in hyperacute phase of spontaneous intracerebral hemorrhage by continuous nicardipine infusion with or without a preceding nicardipine bolus dose

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