Document Detail


Nifedipine infusion in acute myocardial infarction: experience in twelve patients.
MedLine Citation:
PMID:  3690906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Studies of nifedipine have not shown that it reduces myocardial infarct size in humans. These studies did not consider the pharmacokinetics and dynamics of nifedipine. Oral doses of nifedipine cause high plasma concentrations and possibly harmful hemodynamic changes. Intravenous nifedipine infusion can rapidly achieve and maintain a steady concentration without repeated hemodynamic upsets. We studied 24-h intravenous nifedipine infusion in 12 patients with acute myocardial infarct, starting within 6 (mean 4.0 +/- 0.7) h of onset of pain, to determine its safety, pharmacokinetics, and dynamics. An intravenous nifedipine bolus of 15 micrograms/kg was followed by an infusion of 0.9 mg/h for 24 h. After the bolus, pulse rate rose 12.5 +/- 8.0 p less than 0.01) and blood pressure fell (systolic by 20 +/- 34, p less than 0.05, and diastolic by 7.5 +/- 15.6, p less than 0.05). There were similar but lesser changes during the infusion. Myocardial oxygen requirements, as measured by the rate-pressure product, did not increase. The mean nifedipine concentration at steady state was 17.2 +/- 4.2 ng/ml and mean elimination T 1/2 3.57 +/- 2.70 h. Nifedipine was discontinued in 3 patients because of hypotension (SBP less than 90), rapid atrial fibrillation, and complete heart block in one patient each. Seven patients developed thrombophlebitis. Large studies of this preparation examining infarct size limitation and mortality are feasible, although in view of the problems of thrombophlebitis in peripheral veins, shorter infusion times or infusion via central lines would be more acceptable.
Authors:
T J Walley; A M Heagerty; K L Woods; R F Bing; J E Pohl; D B Barnett
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  10     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1987 Dec 
Date Detail:
Created Date:  1988-01-26     Completed Date:  1988-01-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  800-3     Citation Subset:  IM    
Affiliation:
Department of Pharmacology and Therapeutics, University of Leicester, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aged
Blood Pressure / drug effects
Female
Heart Rate / drug effects
Hemodynamics / drug effects
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction / drug therapy*
Nifedipine / administration & dosage,  adverse effects,  pharmacokinetics,  pharmacology*,  therapeutic use
Pilot Projects
Thrombophlebitis / etiology
Chemical
Reg. No./Substance:
21829-25-4/Nifedipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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