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Use of Nifedipine in PIH
Use of Nifedipine in PIH
Use of Nifedipine in PIH
Correspondence: Dr G. Constantine
Abstract
Article
Abstract:
Reported causes of pancreatitis in pregnancy include:
gallstone disease, hyperlipidemia, alcohol ingestion, viral,
and idiopathic. Few reports associate pancreatitis with
pregnancy-induced hypertension. A 35-year-old women
with pregnancy-induced hypertension and spontaneous
rupture of membranes was admitted for induction of labor.
Her postpartum course was complicated by acute renal
failure that responded well to treatment with Lasix and
Albumin. Subsequently, the patient developed acute
pancreatitis and recovered following conservative
treatment. It is possible that the pancreatic ischemia due
to generalized vasoconstriction of preeclampsia and loop
diuretics in the setting of oliguria with renal failure, had a
synergistic effect on the pancreas. Therefore, we suggest
that in postpartum women with pregnancy-induced
hypertension and acute renal failure, diuretics should be
cautiously used because they may increase the risk of
pancreatitis.
• Jayawardana J,
• Lekamge N.
Articles
Abstract:
Summary: We compared antihypertensive efficacy and safety of a
single administration of equipotent doses of lacidipine versus
nifedipine in the hypertensive urgencies. Twenty-nine
asymptomatic essential hypertensive patients (nine men, 20
women) with a mean age of 55.03 +/- 11.19 years and baseline
diastolic blood pressure (DBP) of >=120 mm Hg after resting 30
min, not taking antihypertensive drugs for the last 24 h, were
randomized in a single-blind fashion to receive lacidipine, 4 mg
(LCD, 15 patients) or short-acting nifedipine, 20 mg (NFD, 14
patients) in a single dose. Blood pressure (BP) and heart rate
(HR) were taken every 30 min during the first 8 h and every 2 h
until 24 h of follow-up. Baseline BP values were similar in the two
groups (LCD, 222.5 +/- 32.8/124.6 +/- 8.4 mm Hg vs. NFD, 215.9
+/- 20.6/128 +/- 7.7 mm Hg; p = NS). Both drugs promoted a
significant reduction of systolic blood pressure (SBP; 169.6 +/-
27.8 vs. 170.6 +/- 25.3 mm Hg) and diastolic blood pressure
(DBP; 104.1 +/- 16 vs. 102.9 +/- 12.4 mm Hg) after 8 h. However,
either SBP (165 +/- 27.3 vs. 190.6 +/- 18.2 mm Hg; p = 0.008) and
DBP (99.9 +/- 12.3 vs. 117.2 +/- 11.4 mm Hg; p = 0.001) were
significantly higher in the NFD group after 24-h dosing. Eleven
patients in the LCD group had a decrease in BP >25% of the
baseline value both 8 and 24 h after the dose. Although 10
patients showed the same response in the NFD group 8 h after
the dose, only four patients maintained these values at 24 h. One
patient treated with NFD had a transient cerebrovascular ischemic
attack. No adverse effects were observed in the LCD group. We
conclude that the long-acting calcium antagonist lacidipine was
more effective than the short-acting nifedipine in both controlling
BP and maintaining this BP reduction over 8 h in essential
hypertensive patients with acute asymptomatic BP increase.
Abstract
Summary. The acute effects of a single, 20 mg oral dose of nitrendipine were studied in
10 women at between 32 and 42 weeks gestation with stable pregnancy-induced
hypertension (PIH). Blood pressure (BP), maternal heart rate and fetal heart rate (FHR)
were assessed for 8 h after nitrendipine intake together with the plasma levels of
nitrendipine, noradrenaline, adrenaline, plasma renin activity (PRA) and vasopressin.
The mean initial systolic/diastolic BP was 158 (SEM 3.7)/ 108 (SEM 2.7) mmHg. Within 1
h stable, reduced mean BP-levels of 141–145/90–95 mmHg were reached and
maintained for 4 h after medication. This antihypertensive effect was closely related to
the maternal plasma concentration of nitrendipine, which reached a maximum of 9.1
(SEM 2.6) ng/ml 3 h after tablet intake. After 4 h, systolic and diastolic BPs slowly
increased in parallel to a successive decrease in plasma concentrations of nitrendipine.
Maternal heart rate increased by less than 10%, while FHR remained unchanged. No
hypotensive incidents occurred. The initial mean plasma concentrations of noradrenaline,
adrenaline, vasopressin and PRA did not change during the treatment. No major
maternal and no fetal side-effects were observed. Three of 10 patients experienced mild,
transient facial flushing.
• Neri I,
• Valensise H,
• Facchinetti F,
• Menghini S,
• Romanini C,
• Volpe A.