Comparison of premade clevidipine and pharmacy-prepared nicardipine in time to goal systolic blood pressure in acute cerebrovascular accident

2021 ◽  
Author(s):  
Bethany E Martini ◽  
Amber L Schalk
Keyword(s):  
Blood Pressure ◽  
Adverse Events ◽  
Systolic Blood Pressure ◽  
Cerebrovascular Accident ◽  
Primary Objective ◽  
Inpatient Mortality ◽  
Acute Cerebrovascular Accident ◽  
Lengths Of Stay ◽  
Significant Difference ◽  
Mean Time

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To compare pharmacy-prepared nicardipine and premade clevidipine with regard to time to goal systolic blood pressure (SBP) in acute cerebrovascular accident (CVA). Methods A retrospective, observational study was conducted comparing patients with acute CVA who received nicardipine or clevidipine. The primary objective was time to goal SBP. Secondary objectives included time from order to administration, time from administration to goal SBP, percentage of SBP readings below goal, total volume administered, hospital and intensive care unit lengths of stay, inpatient mortality and adverse events. Results Seventy-one patients were included in the study, 37 in the nicardipine group and 34 in the clevidipine group. A significant difference was found in mean time to goal SBP (150.9 minutes in the nicardipine group vs 69.3 minutes in the clevidipine group, P < 0.01). Time from order to administration was 80.1 minutes in the nicardipine group and 35.2 minutes in the clevidipine group (P < 0.01). Mean time from administration to goal SBP was 70.9 minutes in the nicardipine group and 42.3 minutes in the clevidipine group (P = 0.02). There was no difference between groups in percentage of SBP readings below goal, total volume administered, length of stay, or inpatient mortality. Adverse events occurred in 13 (35.1%) of the nicardipine-treated patients and 17 (50%) of the clevidipine-treated patients (P = 0.42). Conclusion Compared to use of pharmacy-prepared nicardipine, use of premade clevidipine was associated with a shorter time to goal SBP in patients with acute CVA. There were no significant between-group differences in safety outcomes. Premade clevidipine should be considered over pharmacy-prepared nicardipine when rapid blood pressure lowering is warranted in acute CVA.

scholarly journals Differences in brand versus generic esmolol in the treatment of perioperative supraventricular tachycardia and hypertension: A pilot study

2020 ◽  
Vol 8 ◽  
pp. 205031212096233
Author(s):  
Diamanto Aretha ◽  
Panagiotis Kiekkas ◽  
Nektarios Sioulas ◽  
Fotini Fligou
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Pilot Study ◽  
Adverse Events ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Supraventricular Tachycardia ◽  
Brand Name ◽  
Significant Difference

Background: Once a patent expires, generic analogue drugs are alternatives to brand name drugs. Because bioequivalence/biodistribution problems have been reported for many generic analogue drugs, we prospectively evaluated 31 patients to reveal the differences in the doses used and the efficacy and adverse events of two different intravenous esmolol formulations. Methods: This was a prospective observational pilot study. Our aim was to reveal the possible differences in the required doses between two different formulations (brand name drug vs generic analogue drug) of intravenous esmolol in beats per minute, systolic blood pressure, diastolic blood pressure and mean arterial pressure in intra- and postoperative patients with supraventricular tachycardia and hypertension. The patients were categorised into two groups according to the medication they received (brand name drug or generic analogue drug). Results: Esmolol was given to 31 patients (16 generic analogue drug and 15 brand name drug). Although there was a statistically significant difference in bolus (mg/kg) and continued (mg/kg/h) drug dose used (brand name drug/generic analogue drug, mean (standard deviation), 0.3 (0.1) vs 0.38 (0.1), p = 0.03 for bolus dose, and 0.22 (0.09) vs 0.29 (0.08) for continued dose at 10 min (p = 0.03), 0.19 (0.06) vs 0.24 (0.05) at 20 min (p = 0.01) and 0.14 (0.05) vs 0.18 (0.05) at 30 min (p = 0.02)), there were no time-related statistical significant differences in the reduction rates of the two drugs (p = 0.47). There were no time-related statistically significant differences between the two groups in systolic blood pressure, diastolic blood pressure, mean arterial pressure and beats per minute, nor in their adverse events. Conclusion: In this pilot study, smaller doses were given for controlling the patient’s haemodynamics when a brand name drug was used. Because there were no significant time-related differences in the reduction rates of the two drugs nor in any haemodynamic differences between the two groups, optimal titration of the drug used could effectively control the patient’s haemodynamics. The adverse events were also similar in both groups.

scholarly journals Dental anxiety in patients undergoing oral surgery and its effects on blood pressure and heart rate

2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Waiting Room ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Before And After ◽  
Evaluation Anxiety

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.

scholarly journals Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 24-30
Author(s):  
Nasir Uddin Ahmed ◽  
Masuda Islam Khan ◽  
Aynul Islam Khan ◽  
AKM Akhtaruzzaman
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Postoperative Analgesia ◽  
Low Dose ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group A ◽  
Group B ◽  
Mean Time

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.Delta Med Col J. Jan 2016 4(1): 24-30

A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats

2005 ◽  
Vol 7 (3) ◽  
pp. 147-152 ◽  
Author(s):  
Rosanne E. Jepson ◽  
Vivien Hartley ◽  
Michael Mendl ◽  
Sarah ME Caney ◽  
David J Gould
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Measurement ◽  
Systemic Hypertension ◽  
Pressure Measurements ◽  
Non Invasive ◽  
Measuring Devices ◽  
Oscillometric Device ◽  
Significant Difference

Indirect blood pressure measurements were compared in 28 conscious cats using Doppler and oscillometric blood pressure-measuring devices. Ten cats were used to compare Doppler measurements between two examiners and 18 cats were used to compare Doppler and oscillometric measurements. The Doppler machine obtained systolic and diastolic blood pressure readings in 100% and 51% of attempts, respectively. With the oscillometric machine, systolic and diastolic blood pressure readings were obtained in 52% of the attempts. With the Doppler, measures of mean systolic blood pressure between two examiners were positively correlated, but there was no correlation for diastolic blood pressure measures. When comparing the results obtained by Doppler and oscillometric machines there was no significant difference between mean systolic blood pressure readings, but the oscillometric machine produced significantly higher estimates of diastolic blood pressure. In both cases, the standard deviations for the oscillometric machine were considerably larger than those for the Doppler machine. The first reading of systolic blood pressure obtained with the Doppler machine was an excellent predictor of the mean of five readings, but this was not so for the oscillometric machine. It took less than 5 min to obtain five readings in 37.5% of cases with the Doppler machine but this was true for only 5% of cases with the oscillometric machine. Two cats with ophthalmological lesions consistent with systemic hypertension were identified. In these two patients, systolic blood pressure measurements were between 200 and 225 mmHg when measured by Doppler, and between 140 and 150 mmHg when measured by the oscillometric machine. This suggests that a lower reference range for normal systolic blood pressure values should be used for the oscillometric device.

The Epidemiology of Plasma Renin

1983 ◽  
Vol 64 (3) ◽  
pp. 273-280 ◽  
Author(s):  
T. W. Meade ◽  
J. D. Imeson ◽  
D. Gordon ◽  
W. S. Peart
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Blood Cholesterol ◽  
Occupational Groups ◽  
Predisposing Factor ◽  
Significant Difference ◽  
Epidemiological Characteristics

1. The epidemiological characteristics of plasma renin activity (PRA) were established in 1999 members of occupational groups in North and West London. 2. The main finding was that PRA was inversely associated with systolic blood pressure in men, the percentage fall in PRA (on a log scale) being 8.4% for each increase of one standard deviation in systolic blood pressure. There was a less obvious inverse relationship in women. 3. However, blood pressure accounted for less than 1% of the variance in PRA. 4. Mean PRA in both smokers and ex-smokers was about 20% higher than in non-smokers. 5. PRA fell with increasing age, was lower in women than in men and considerably lower in blacks (of either sex) than whites. 6. PRA was lower in the first quarter of the menstrual cycle than in the rest of the cycle. 7. Haemoglobin, blood cholesterol, leucocyte count and Factor VIII were positively correlated with PRA. 8. PRA was lower in men with diagnosed hypertension than in those without; there was no significant difference in the women. 9. PRA was lower in those who had had myocardial infarcts in the past than in those who had not. 10. The data as a whole suggest that it may be low, not high, levels of PRA which are associated with increased risks of cardiovascular disease in which hypertension is a predisposing factor. 11. The explanation may be a homoeostatic fall in PRA in response to a rise in blood pressure rather than a major causal role for PRA in the pathogenesis of essential hypertension and target-organ damage.

General versus locoregional anesthesia in carotid surgery: A prospective randomised trial

VASA ◽  
2006 ◽  
Vol 35 (4) ◽  
pp. 232-238 ◽  
Author(s):  
Kasprzak ◽  
Altmeppen ◽  
Angerer ◽  
Mann ◽  
Mackh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Carotid Endarterectomy ◽  
Randomised Trial ◽  
Complication Rates ◽  
Cardiopulmonary Complication ◽  
Locoregional Anesthesia ◽  
Significant Difference ◽  
Ica Stenosis

Background: To evaluate the influence of anesthetic technique on perioperative neurological and cardiopulmonary complication rates in patients undergoing carotid endarterectomy. Patients and methods: 186 patients with symptomatic internal carotid artery (ICA) stenosis > 70% or asymptomatic ICA stenosis > 80% were prospectively randomized for either locoregional (LA) or general anesthesia (GA). Results: Neurological complication rates were similar in both groups (GA 2% vs. LA 2%). Cardiopulmonary complication rates were not significantly different (GA 4% vs LA 1%).There were no stroke-related deaths, but one patient from the GA group died from severe postoperative pneumonia. Thus, a significant difference in combined stroke / cardiopulmonary related death between the two groups (GA 1% vs LA 0%) could not be found. However, perioperative cardiopulmonary monitoring showed that significantly more patients operated under general anesthesia had hypertensive events, with systolic blood pressure values greater than 180 mmHg on postoperative day one. There were no differences in the number of postoperatively hypotensive episodes (systolic blood pressure values < 100 mmHg) between the two groups. Conclusions: Significant differences in the perioperative neurological and cardiopulmonary complication rates between general and locoregional anesthesia in patients undergoing carotid endarterectomy could not be observed.

scholarly journals The Effect of Neuropeptide Y (NPY) rs 16147 Gene Polymorphism on the Blood Pressure of Chronic Kidney Disease Patients and Control Healthy in Medan, Indonesia

2021 ◽  
Vol 8 (8) ◽  
pp. 319-326
Author(s):  
Gabriel Pardamean ◽  
Riri Andri Muzasti ◽  
Syafrizal Nasution
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gene Polymorphism ◽  
Systolic Blood Pressure ◽  
Neuropeptide Y ◽  
Dna Analysis ◽  
Pathological Condition ◽  
Significant Difference ◽  
And Control

Introduction: Chronic Kidney Disease (CKD) is a pathological condition that occurs gradually and is irreversible, characterized by structural and functional abnormalities in the kidneys that lasts for more than three months. The C allele in the Neuropeptide Y (NPY) RS16147 gene is closely related to an increase in the incidence of hypertension, a decrease in glomerular filtration rate, and an increase in total cholesterol levels in CKD patients. Objective: To determine the effect of the NPY RS16147 gene polymorphism on the blood pressure of chronic kidney disease patients and control healthy in Medan Indonesia. Methods: This study is an analytical study with a case-control design at the Haji Adam Malik General Hospital Medan from July to August 2020. All subjects had Deoxyribonucleic Acid (DNA) analysis using Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) method. Results: We obtained 100 study subjects, 43 was CKD patients with dialysis, 31 CKD patients without dialysis, and 26 control healthy groups. In this study, there were differences in the trend genotypes of NPY RS16147 polymorphism with the incidence of CKD and control healthy. We obtained a significant difference the mean systolic blood pressure patients with genotypes TT (139,05±21,42) and TC/CC (151,32±22,26) as evidenced by the value of P = 0.00 (≤0.05). The presence of the "C" allele in the NPY RS16147 gene sample increased blood pressure in all study subjects significantly (P=0.028; ≤0.05). Conclusion: the "C" allele in the NPY RS16147 gene affects systolic blood pressure. Keywords: NPY RS16147 polymorphism, Chronic kidney disease, Blood pressure.

scholarly journals Clinical outcomes in hypertension patients after coronary stenting due to exertional angina

2020 ◽  
Vol 25 (3) ◽  
pp. 3736
Author(s):  
R. N. Akhtereyev ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
Z. M. Galeeva
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Clinical Outcomes ◽  
Cerebrovascular Accident ◽  
Coronary Stenting ◽  
Class Iii ◽  
Acute Cerebrovascular Accident ◽  
Exertional Angina ◽  
Class Iv

Aim. To study clinical outcomes in hypertension patients after coronary stenting due to exertional angina.Material and methods. The study included 214 patients with class 3 stable angina and hypertension. All patients underwent coronary angiography followed by elective stenting. Clinical outcomes were assessed on average after 44 months of outpatient follow-up.Results. During the follow-up period, 43% of patients retained class III angina; the decrease in systolic (SBP) and diastolic blood pressure (DBP) was 18and 14-mm Hg, respectively. There were 35 cases of myocardial infarction (MI) in this category of subjects. We revealed that 57% of patients had a progression of angina: from class III to class IV; the decrease in SBP and DBP was 10and 18-mm Hg, respectively. There were 110 cases of MI and 10 cases of acute cerebrovascular accident in these patients.Conclusion. Inadequate control of SBP in patients after stenting due to stable exertional angina leads to a greater number of complications, mainly myocardial infarction.

Sign in / Sign up

Export Citation Format

Share Document