Therapeutic Uses of Calcium Channel-Blocking Drugs in the Young

Cho, Cornelia

doi:10.1001/archpedi.1986.02140180094034

Cited by 7 publications

(1 citation statement)

References 78 publications

(5 reference statements)

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“…To emergently improve peripheral circulation, multiple vasodilators may also be initiated. Calcium channel blockers are first‐line options because of their well‐demonstrated efficacy in childhood ischemic disorders (11,12). Additionally, topical nitroglycerin paste may be applied to the base of the palms and the soles of affected extremities to help relieve ischemia with rapid localized vasodilatation (13).…”

Section: Discussionmentioning

confidence: 99%

Distal Extremity Necrosis as a Manifestation of Cutaneous Polyarteritis Nodosa: Case Report and Review of the Acute Management of a Pediatric Patient

Williams¹,

Guirola

Flemming³

et al. 2012

Pediatric Dermatology

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We present the case of an 8-year-old girl who presented with distal extremity necrosis of the hands, feet, nose, and ears as an acute manifestation of cutaneous polyarteritis nodosa (CPAN). She was emergently managed with intravenous steroids, nifedipine, sildenafil, pentoxifylline, nitroglycerin paste, aspirin, low-molecular-weight heparin, and intravenous gamma globulin. The necrosis was controlled, and reperfusion was attained to salvage the extremities. It is important for clinicians to be aware that acute distal extremity necrosis can be a manifestation of CPAN in children. Etiology is often not clear on presentation, but once infection is excluded, acute management with systemic steroids and systemic vasodilators is indicated regardless of the cause. Iloprost and bosentan may represent options for adjunctive vasodilators. More studies are needed to create guidelines for the acute and long-term management of these children. Close follow-up of children with CPAN, especially with a history of vaso-occlusive symptoms, is important to allow prompt intervention in the event of distal extremity infarction.

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Section: Discussionmentioning

confidence: 99%

Distal Extremity Necrosis as a Manifestation of Cutaneous Polyarteritis Nodosa: Case Report and Review of the Acute Management of a Pediatric Patient

Williams¹,

Guirola

Flemming³

et al. 2012

Pediatric Dermatology

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Calcium Channel-Blocking Drugs

Miller‐Hance

1986

Arch Pediatr Adolesc Med

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Treatment of hypertensive crisis in children with nifedipine

et al. 1988

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We report 31 episodes of hypertensive crises in children, managed with sublingual nifedipine at the following dosages: 10 mg in children with body weight (BW) higher than 20 kg, 5 mg in children with BW between 10 and 20 kg, and 2.5 mg in children with BW below 10 kg. The mean initial blood pressures were 161.41 mm Hg for the systolic pressure (mSBP) and 111.25 mm Hg for the diastolic pressure (mDBP). After nifedipine, both the mSBP and the mDBP decreased, with onset of effect five minutes after dosage and maximum decrease at 60 min (mSBP 134.93 mm Hg, mDBP 79.23 mm Hg, for decreases of 16.4 and 28.7%, respectively), and this effect persisted for 180 min. Blood pressure increased again from min 240 to min 360, yet without reaching the initial levels. One case did not respond to the first dose of nifedipine and required a second one. The effect of nifedipine was more pronounced on the DBP than on the SBP, and greater reductions of both pressures were achieved in the cases with higher initial readings. No side of medication were observed in our patients.

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Therapeutic Uses of Calcium Channel-Blocking Drugs in the Young

Cited by 7 publications

References 78 publications

Distal Extremity Necrosis as a Manifestation of Cutaneous Polyarteritis Nodosa: Case Report and Review of the Acute Management of a Pediatric Patient

Distal Extremity Necrosis as a Manifestation of Cutaneous Polyarteritis Nodosa: Case Report and Review of the Acute Management of a Pediatric Patient

Calcium Channel-Blocking Drugs

Treatment of hypertensive crisis in children with nifedipine

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