EDUCATION CORNER

Neuroanesthesia Keyword: Nicardipine

Reza Gorji, MD
Executive Editor

Fenghua Li, MD
Editor-in-Chief

Reja Gordi, MD
Reza Gorji, MD
Fenghua Li, 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.

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