Posted by cybercafe on July 31, 2002, at 22:22:04
In reply to Re: MAOI diet short list, posted by jsarirose on July 30, 2002, at 23:16:01
maybe chlorpromazine is better than nifedepine:Weekly Web Review in Emergency Medicine
Article Review: January 31, 1997
SHOULD A MORATORIUM BE PLACED ON SUBLINGUAL NIFEDIPINE CAPSULES GIVEN FOR HYPERTENSIVE EMERGENCIES AND PSEUDOEMERGENCIES?
Grossman E, Messerli FH, Grodzicki T, et al. JAMA, October 23/30, 1996; 276:1328BACKGROUND: Nifedipine is a peripheral vasodilator that produces hypotension, along with reflex tachycardia and myocardial contractility. Although sublingual short-acting nifedipine is often given in the emergency department to rapidly lower elevated blood pressure, such use has not been approved by the Food and Drug Administration. The safety of this practice has never been demonstrated; in fact, adverse effects associated with nifedipine-induced precipitous blood pressure reduction include cerebral ischemia and infarction, acute myocardial infarction, complete heart block, and death. In actual hypertensive emergencies (severe hypertension with secondary encephalopathy, stroke, myocardial infarction, dissecting aortic aneurysm, or acute renal failure), more reliable and controllable agents such as intravenous nitroprusside are indicated. In other settings, physician attempts to lower blood pressure acutely are often merely "blood pressure cosmetics," with significant risks but little potential benefit. The authors conclude that the routine use of short-acting nifedipine capsules in hypertensive emergencies and pseudoemergencies should be abandoned.
poster:cybercafe
thread:75408
URL: http://www.dr-bob.org/babble/20020731/msgs/114715.html