Document Detail


The potential use of nicardipine in cerebrovascular disease.
MedLine Citation:
PMID:  2911983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E S Flamm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  117     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1989 Jan 
Date Detail:
Created Date:  1989-02-15     Completed Date:  1989-02-15     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  236-42     Citation Subset:  AIM; IM    
Affiliation:
Division of Neurosurgery, University of Pennsylvania, Philadelphia 19104.
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MeSH Terms
Descriptor/Qualifier:
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:
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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