Neuroanesthesia Keyword: Nicardipine
Reza Gorji, MD
Fenghua Li, MD
|Reza Gorji, MD|
|Fenghua Li, MD|
Drug Class: Dihydropyridine class of calcium channel blockers.
Similar Drugs: Nifedipine, amlopidine and felodipine; Nicardipine is more selective for cerebral and coronary blood vessels.
Indication: Treatment of hypertension; used especially in neuroanesthesia and patients with subarchnoid hemorrhage.
Dosing: 2-15 mg/hr starting at lower end of dosing.
Mechanism of Action: Calcium channel blocker relaxes arterial vascular muscle. Little change in chronotropy and dromotropy; direct acting vasodilator which binds to voltage-gated Ca++ channel in cell membrane and inhibit Ca++ influx. Half-life is 3-12 hours.
Onset of Action: 1-3 min.
Clearance: Hepatic metabolism with renal and biliary excretion.
Contraindications: Severe aortic stenosis, decompensated congestive heart failure.
Side Effects: Hypotension, flushing, headaches and reflex tachycardia.