Use of the calcium-channel blocker nifedipine in the management of hypertensive emergency.
Nifedipine, a well-tolerated calcium-channel blocking drug, is known to produce a rapid and vigorous vasodilating effect on the peripheral vasculature. In order to determine its effectiveness in rapidly treating moderately severe hypertension, nifedipine was administered buccally to 63 patients. Ten-milligram capsules, perforated ten times with a 26-gauge needle, were chewed by patients to expel the viscous drug within them. If one capsule was not sufficiently effective within 20 to 30 minutes, a second capsule was administered similarly. The drug was administered to 63 patients with diastolic blood pressure of 120 mm Hg or greater, or systolic blood pressure of 200 mm Hg or greater with a diastolic blood pressure in excess of 90 mm Hg. Forty-two patients responded to 10 mg of nifedipine, with a drop in blood pressure from a mean (+/- SD) of 205.5 +/- 24.4/127.7 +/- 11.7 mm Hg to 158.6 +/- 24.7/88.8 +/- 10 mm Hg in 39.9 +/- 13.0 minutes. Nineteen patients responded to two doses of nifedipine (20 mg), with a drop in blood pressure from 212.1 +/- 27.1/128.2 +/- 17.3 mm Hg to 165.4 +/- 24.5/93.8 +/- 10.7 mm Hg after 66.0 +/- 17.8 minutes. There were no side effects and no hypotension, even among the 38 patients who had recently received other medications, including beta blockers, diuretics, hydralazine, methyldopa, captopril, and clonidine. It is our conclusion that the chewing of nifedipine capsules is a safe and effective method to lower blood pressure promptly without the use of parenteral medications.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002214:Capsules; D004630:Emergencies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*
D002214:Capsules; D009543:Nifedipine