Conrad K A, Fagan T C, Mayshar P, Davis T P, Johnson D G
Clin Pharmacol Ther. 1987 Jul;42(1):113-8. doi: 10.1038/clpt.1987.118.
We studied the safety and efficacy of intravenous nicardipine alone and in combination with oral captopril. Sixteen patients with essential hypertension received a single oral dose of captopril, 50 mg, to be certain that excessive hypotension would not occur. Nicardipine was given intravenously as a 2 mg bolus, followed by an infusion at a rate designed to lower the supine diastolic blood pressure at least 10 mm Hg; then oral captopril, 50 mg, or placebo was given. The next week, nicardipine was again infused, but the alternate oral treatment was given. Intravenous nicardipine reduced blood pressure from 156 +/- 15/101 +/- 5 mm Hg (mean arterial blood pressure 120 +/- 6 mm Hg) to 140 +/- 11/88 +/- 4 mm Hg (mean arterial blood pressure 105 +/- 5 mm Hg). When captopril was added to nicardipine, the mean arterial blood pressure fell an additional 8 mm Hg but the heart rate did not increase. The combination of angiotensin-converting enzyme inhibition and calcium channel blockage produces additive antihypertensive effects without additional reflex tachycardia.
我们研究了静脉注射尼卡地平单独使用以及与口服卡托普利联合使用的安全性和有效性。16例原发性高血压患者口服单剂量50毫克卡托普利，以确保不会出现过度低血压。静脉注射2毫克尼卡地平推注剂量，随后以旨在使仰卧位舒张压至少降低10毫米汞柱的速率进行输注；然后给予50毫克口服卡托普利或安慰剂。下周，再次输注尼卡地平，但给予交替的口服治疗。静脉注射尼卡地平使血压从156±15/101±5毫米汞柱（平均动脉血压120±6毫米汞柱）降至140±11/88±4毫米汞柱（平均动脉血压105±5毫米汞柱）。当卡托普利添加到尼卡地平中时，平均动脉血压又下降了8毫米汞柱，但心率没有增加。血管紧张素转换酶抑制和钙通道阻滞的联合产生相加的降压作用，而不会出现额外的反射性心动过速。
