Document Detail


A comparison of nicardipine and labetalol for acute hypertension management following stroke.
MedLine Citation:
PMID:  18250979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Evaluate the ease of use and tolerability of labetalol (L) and nicardipine (N) for hypertension management in patients with acute stroke. METHODS: This is a retrospective, non-randomized study. Consecutive adults within 24 h of hospital admission who received intravenous bolus labetalol or nicardipine infusion as first-line antihypertensive therapy were identified. Hemodynamic data were collected through 24 h of therapy. RESULTS: Ninety patients received either labetalol (N = 64) or nicardipine (N = 26) initially for blood pressure (BP) management. Stroke types were 54% intracerebral hemorrhage (ICH), 22% subarachnoid hemorrhage, and 23% ischemic stroke and were similar between the two drug groups. Baseline patient characteristics and disease severity (APACHE II and GCS) were similar between groups. The average total daily labetalol dose was 40 (10-340) mg and nicardipine infusion was 5 (1-14) mg/h. Initial BP was similar in the two groups. The nicardipine group had less BP variability (N 8.19 vs. L 10.78 mmHg; p = 0.003), fewer dosage adjustments [L 4 (1-17), N 2 (0-5); p < 0.001] and fewer additional antihypertensive agents (L 33%, N 8%; p = 0.013) administered during the 24-h observation period. In patients with ICH, 33% of nicardipine-treated patients achieved target BP within the first 60 min versus 6% of the L group (p = 0.02). Overall, incidence of hypotension (SBP < 90 mmHg) (L 3%; N 0%) and bradycardia (HR < 60 beats per min) (L 20.6%; N 12%) were comparable between the groups. CONCLUSIONS: Nicardipine offers an alternative to labetalol with similar tolerability and appears to provide a smoother blood pressure control compared to labetalol.
Authors:
Xi Liu-Deryke; James Janisse; William M Coplin; Dennis Parker; Gregory Norris; Denise H Rhoney
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  9     ISSN:  1541-6933     ISO Abbreviation:  Neurocrit Care     Publication Date:  2008  
Date Detail:
Created Date:  2008-09-23     Completed Date:  2008-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-76     Citation Subset:  IM    
Affiliation:
Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, 48201, USA.
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MeSH Terms
Descriptor/Qualifier:
APACHE
Acute Disease
Aged
Antihypertensive Agents / administration & dosage*
Blood Pressure / drug effects
Brain Ischemia / complications
Cerebral Hemorrhage / complications
Female
Humans
Hypertension / complications*,  drug therapy*
Labetalol / administration & dosage*
Male
Middle Aged
Nicardipine / administration & dosage*
Retrospective Studies
Stroke / complications*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 36894-69-6/Labetalol; 55985-32-5/Nicardipine

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


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