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[Treatment of hypertensive attacks in children with nicardipine]
Insights
Nicardipine effectively treats hypertensive emergencies in children, lowering blood pressure significantly. This calcium channel blocker is well-tolerated and maintains vital organ blood flow.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Pharmacology
Context:
- Malignant hypertension in children presents a critical medical challenge.
- Effective and safe management of hypertensive emergencies is crucial for preventing end-organ damage.
Purpose:
- To evaluate the efficacy and safety of nicardipine in treating hypertensive emergencies in pediatric patients.
- To determine an optimal dosage and duration of action for nicardipine in this population.
Summary:
- A prospective study administered nicardipine 65 times to 6 children with malignant hypertension.
- Nicardipine demonstrated significant hypotensive effects, reducing mean arterial blood pressure by 28-38% within 90 minutes.
- The drug was well-tolerated and maintained cerebral, renal, and myocardial blood flow.
Impact:
- Nicardipine is a valuable therapeutic option for pediatric hypertensive emergencies.
- A dosage of 1 mg/kg/dose, 3-4 times daily, appears effective with effects lasting 6-10 hours.
- Management requires integration with long-term antihypertensive strategies.
Abstract:
A prospective study of the hypotensive effects of nicardipine has been performed during 65 administrations of the drug in 6 children with malignant hypertension. We conclude that this calcium channel blocker is useful to treat hypertensive emergency in children owing to its tolerance and its efficacy (mean arterial blood pressure was lowered by 28 to 38% after 90 min). In addition, it ensures the maintenance of cerebral, renal and myocardial blood flow. A posology of 1 mg/kg/dose, 3 or 4 times/day (oral route) seems to be sufficient, as its effects last 6 to 10 h. Nevertheless the control of acute arterial hypertension must always be associated with the introduction or adjustment of long-term antihypertensive therapy.