Nicardipine Overview and Clinical Use

Study Notes

Nicardipine Overview

Nicardipine is a calcium channel blocker (CCB).
It is a dihydropyridine CCB.
Primarily used as an antihypertensive agent.
Used for managing acute hypertension.

Mechanism of Action

Inhibits calcium ion influx into vascular smooth muscle cells.
This relaxation causes vasodilation.
Systemic vasodilation reduces peripheral resistance, lowering blood pressure.

Pharmacokinetics

Rapidly absorbed orally, but low bioavailability (~30%) due to first-pass metabolism.
Extensively metabolized in the liver.
Major metabolites are inactive and cleared by the kidneys.
Elimination half-life is 5-8 hours.

Clinical Uses

Treats essential hypertension.
Used in hypertensive emergencies (e.g., acute stroke, severe preeclampsia).
Often administered intravenously for rapid onset in emergencies.
Used for ischemic chest pain refractory to other treatments.
Used cautiously in patients with severe left ventricular dysfunction or other cardiac conditions.

Administration

Commonly given intravenously for rapid onset, especially in emergencies.
Available in oral forms for chronic hypertension management.
Oral administration has a slower onset of action.

Side Effects

Common: headache, flushing, dizziness, peripheral edema.
Less common but serious: hypotension, bradycardia, arrhythmias (especially with IV).
Reflex tachycardia is a possible adverse effect due to vasodilation.

Contraindications

Hypersensitivity to nicardipine or other dihydropyridine CCBs.
Caution with severe hypotension, acute myocardial infarction, or severe hepatic dysfunction.
Use during pregnancy and lactation only if benefits outweigh risks.

Drug Interactions

Significant interactions with other vasodilators, antihypertensives, and medications affecting hepatic metabolism.
Caution when combining with medications decreasing cardiac output.

Dosage Considerations

Individualized based on patient response and continuous blood pressure monitoring.
IV nicardipine starting dose and titration carefully adjusted based on initial blood pressure and clinical status.
Oral dosage adjustments with careful blood pressure monitoring and adverse effect observation.

Special Considerations

Secondary choice for hypertension management if first-line agents are ineffective or poorly tolerated.
Patient education on potential side effects, and the need for regular blood pressure monitoring, is crucial.

Description

This quiz covers the essential aspects of Nicardipine, a dihydropyridine calcium channel blocker. Learn about its mechanism of action, pharmacokinetics, and the clinical applications in managing hypertension. Assess your understanding of this important antihypertensive medication.

Nicardipine Overview and Clinical Use

Choose a study mode

Podcast

Questions and Answers

What is a critical consideration when prescribing nicardipine?

How should the dosage of nicardipine be determined?

When might nicardipine be utilized in hypertension management?

Which of the following is a key aspect of patient education regarding nicardipine?

What should be closely monitored when titrating the dosage of IV nicardipine?

What is the primary mechanism by which nicardipine lowers blood pressure?

Which condition is NOT a typical use for nicardipine?

What is the primary route of administration for nicardipine in hypertensive emergencies?

What is a common side effect of nicardipine?

What factor significantly affects the bioavailability of nicardipine?

Which of the following conditions requires caution when prescribing nicardipine?

What is the elimination half-life range of nicardipine?

What is the nature of the metabolites produced from nicardipine metabolism?