Prlesi Lendita, Cheng-Lai Angela
Department of Pharmacy, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Cardiol Rev. 2009 May-Jun;17(3):147-52. doi: 10.1097/CRD.0b013e31819fe23c.
Hypertension is the most common cardiovascular condition in the United States. It can lead to end organ damage and increased mortality risk if it is not properly controlled. In most situations where blood pressure has to be brought down quickly, an intravenous agent with a quick onset of action is often used. Clevidipine is the first third-generation IV dihydropyridine calcium channel blocker that has a high degree of vascular selectivity and an ultra-fast onset and offset of blood pressure lowering effect. In various clinical trials, clevidipine has shown to be safe and effective in controlling acute blood pressure elevations in patients with hypertensive emergencies, preoperative hypertension, and postoperative hypertension. The most common adverse events noted are atrial fibrillation, nausea, headache, and acute renal failure. Overall, clevidipine is a useful addition to available intravenous agents in reducing blood pressure during acute situations. The acceptance of this agent to hospital formularies may ultimately depend on its perceived ease of administration, clinically relevant benefits over other available agents, and acquisition costs.
高血压是美国最常见的心血管疾病。如果控制不当,它会导致终末器官损害并增加死亡风险。在大多数需要迅速降低血压的情况下,通常会使用起效迅速的静脉用药。克立夫定是首个第三代静脉用二氢吡啶类钙通道阻滞剂,具有高度的血管选择性,降压作用起效极快且作用消失也快。在各种临床试验中,克立夫定已证明在控制高血压急症、术前高血压和术后高血压患者的急性血压升高中是安全有效的。最常见的不良事件是心房颤动、恶心、头痛和急性肾衰竭。总体而言,在急性情况下降低血压时,克立夫定是现有静脉用药中的一种有用补充。该药物被医院处方集接受与否最终可能取决于其给药的便捷性、相对于其他现有药物的临床相关益处以及购置成本。