Subcutaneous Administration of Nifedipine
Drug Intelligence & Clinical PharmacyPublished 1 November 1988
Daniel W. Krichbaum, Patrick M. Malone
Citations6
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TL;DR
Subcutaneous administration of nifedipine was administered subcutaneously to a patient with hypertensive urgency due to misinterpretation of a physician's order and the drug apparently had its desired hypotensive effect.
Abstract
Contents of a 10 mg nifedipine capsule (0.33 ml) were withdrawn by syringe and administered subcutaneously to a patient with hypertensive urgency due to misinterpretation of a physician's order. The drug apparently had its desired hypotensive effect and no adverse effects were noted. The literature on use of nifedipine in hypertensive urgency is reviewed. Subcutaneous administration is not recommended because of a lack of suitable controlled studies and the potential for adverse effects.
Keywords
Medicine
BMJNifedipine in hypertensive emergencies.
226 Citations1983Osmund Bertel, D Conen +4 more
Nifedipine is a simple, effective, and safe alternative drug for managing hypertensive emergencies, especially when continuous monitoring of the patient cannot be guaranteed.
The Journal of Clinical PharmacologyNifedipine Kinetics and Bioavailability After Single Intravenous and Oral Doses in Normal Subjects
196 Citations1983Thomas S. Foster, Scott R. Hamann +4 more
Evaluating the kinetics and bioavailability of nifedipine in 12 normal subjects after single intravenous and oral doses found profiles consistent with fast and slow absorption, with marked variability in the rate of appearance of the drug in plasma.
CHEST JournalEfficacy of Sublingual Nifedipine in the Acute Treatment of Systemic Hypertension
140 Citations1981Nusen Beer, Iván Gallegos +4 more
Nifedipine is an effective and safe hypotensive drug in the rapid management of moderate to severe hypertension and seems to be an effective nonparenteral agent for treatment of hypertensive emergencies.
The LancetNEGLIGIBLE SUBLINGUAL ABSORPTION OF NIFEDIPINE
119 Citations1987J. Van Harten, Meindert Danhof +3 more
The sublingual absorption of nifedipine was investigated in 11 healthy volunteers and absorption was slow and led to low plasma levels, while after the subjects bit a capsule and swallowed a capsule, absorption was faster and higher plasma levels were achieved.
Archives of Internal MedicineSymptomatic Hypotension Induced by Nifedipine in the Acute Treatment of Severe Hypertension
99 Citations1987Robert M. Wachter
A review of the literature reveals no previous reports of symptomatic hypotension from the use of nifedipine alone in this setting, and clinicians should be aware of this potentially life-threatening toxicity and titrate doses and monitor patients accordingly.
JAMAHypertensive Emergencies and Urgencies
92 Citations1986Roger K. Ferguson
Important considerations in the treatment of patients with markedly elevated blood pressure based on an operational classification of hypertensive emergencies and urgencies are reviewed.
Archives of Internal MedicineChewing Nifedipine to Rapidly Treat Hypertension
89 Citations1984Jacob I. Haft
Chewing perforated nifedipine capsules is a safe and effective method to lower BP promptly without parenteral medications.
The American Journal of MedicineEfficacy and safety of sublingual nifedipine in hypertensive emergencies
78 Citations1985A. Gray Ellrodt, Mark J. Ault +2 more
The results suggest that sublingual nifedipine is a safe, effective, and practical agent for treating patients with hypertensive emergencies and in one patient, flushing and another symptom suggestive of transient symptomatic hypotension developed after treatment with nifingipine.
The American Journal of MedicineKinetics and dynamics of nifedipine after oral and sublingual doses
74 Citations1986R. G. McAllister
The small time lag in absorption that may be attributed to the dissolution of the nifedipine capsule may be obviated by biting through the capsule and swallowing the contents; this bite-and-swallow approach to dosing provides the most rapid rise in plasma nifingipine concentrations, and produces peak levels well above those achieved with sublingual administration.
American Heart JournalTreatment of hypertensive urgencies and emergencies with nifedipine
58 Citations1986Mark C. Houston
The role of nifedipine in the treatment of hypertensive emergencies is promising, but further studies are needed to compare it to other approved emergency antihypertensive regimens.
American Heart JournalCurrent concepts in treatment of hypertensive emergencies
49 Citations1986Donald G. Vidt
Whereas an oral loading regimen may be appropriate for management of hypertensive urgencies, parenteral antihypertensive agents are most appropriate for the initial management of a hypertensive emergency.
Medical Clinics of North AmericaHypertensive Crisis
30 Citations1986R. Parker McRae, Philip R. Liebson
Archives of Internal MedicineManagement of Perioperative Hypertension Using Sublingual Nifedipine
24 Citations1986A Adler
This is the first reported study demonstrating the efficacy and safety of using sublingual nifedipine for the management of perioperative hypertension and a prompt antihypertensive response was obtained without any serious side effects.
American Heart JournalCurrent concepts in treatment of hypertensive urgencies
15 Citations1986Ron J. Anderson, William Reed
The correlation between hypertension and endorgan damage is now well recognized, although there is no definite systolic or diastolic level of blood pressure that by itself can be used to distinguish between a hypertensive emergency and an urgency in individual patients.
American Heart JournalRectal administration of perforated nifedipine capsules to maintain an effective level of longer duration
2 Citations1986Masamichi Ishikawa, Naji Yokota +5 more
Plasma nifedipine levels were determined by gas chromatography using a non-radioactive electron capture detector (Yanaco G 2800-EN, Tokyo, Japan) and the minimum detectable concentration was 0.5 rig/ml.