| The potential use of nicardipine in cerebrovascular disease. | |
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MedLine Citation:
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PMID: 2911983 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The efficacy of intravenous nicardipine in the prevention of vasospasm after subarachnoid hemorrhage has been investigated in a dose escalation study in 67 patients admitted within 1 week of subarachnoid hemorrhage. Favorable outcomes were noted in 52 patients (78%). Vasospasm was found by arteriography in 31 patients (46%). A dose-related trend was noted. At the lower dose levels, angiographic spasm was observed in 68% and symptomatic vasospasm in 27% of 34 patients. Only eight of 33 patients (24%) treated at the highest dose level (approximately 10 mg/hr) developed arteriographic evidence of vasospasm. Symptomatic vasospasm was diagnosed in only two of 33 patients (6%) treated with this dose. No deaths from vasospasm occurred. Verification of changes in tissue calcium has been obtained from the rat middle cerebral artery occlusion model, and we concluded that nicardipine administered after permanent occlusion may offer protection against cerebral ischemia in this animal model. Nicardipine uptake was greater at the infarct site than in surrounding tissue, with the highest concentration in the area of maximal ischemia. Nicardipine appears to affect changes in Ca2+ more than other ions: it significantly reduced Ca2+ accumulation in the territory of the middle cerebral artery by 60% at 6 hours, and significantly reduced Na+ and K+ shifts in the same territory by 40% and 50%, respectively, at 6 hours. Although much research remains to be done, a wide role for the dihydropyridines in a number of cerebrovascular conditions is emerging. |
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Authors:
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E S Flamm |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 117 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1989 Jan |
Date Detail:
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Created Date: 1989-02-15 Completed Date: 1989-02-15 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 236-42 Citation Subset: AIM; IM |
Affiliation:
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Division of Neurosurgery, University of Pennsylvania, Philadelphia 19104. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Body Water / metabolism Brain / metabolism Brain Ischemia / drug therapy*, metabolism Calcium / metabolism Humans Ischemic Attack, Transient / drug therapy*, etiology Nicardipine / pharmacokinetics, therapeutic use* Potassium / metabolism Rats Sodium / metabolism Subarachnoid Hemorrhage / complications |
| Chemical | |
Reg. No./Substance:
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55985-32-5/Nicardipine; 7440-09-7/Potassium; 7440-23-5/Sodium; 7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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