Sublingual nifedipine in acute severe hypertension.

Evans, Jeff; Shaw, Nicholas; Brocklebank, J T

doi:10.1136/adc.63.8.975

Cited by 33 publications

(15 citation statements)

References 2 publications

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“…As a first-dose effect, SA nifedipine was effective 76.4% of the time. Previous published reports of efficacy of SA nifedipine substantiate our own experience of its effectiveness [13,18,19,25,26,27,29,30]. The presence of concomitant usage of a long-acting antihypertensive agent, or the presence of co-morbid conditions, did not affect the effectiveness of SA nifedipine.…”

Section: Discussionsupporting

confidence: 88%

“…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: 98%

“…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%

“…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%

“…Patients were excluded from the study if they did not fulfill the above definition and/or if they received an intravenous antihypertensive medication 4 hours prior to the administration of an oral SA antihypertensive medication. Patients who were already on long-acting antihypertensive medications (including long-acting calcium channel blockers) were not excluded, since we wanted to analyze the effects of SA nifedipine for breakthrough severe hypertension while on long-term treatment [18,19].…”

Section: Study Subjectsmentioning

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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