Clevidipine for Perioperative Blood Pressure Control in Infants and Children

Overview

Journal Pharmaceuticals (Basel)

Publisher MDPI

Specialty Chemistry

Date 2013 Nov 27

PMID 24275788

Citations 6

Authors

Joseph D Tobias

David B Tulman

Sergio D Bergese

Affiliations

Soon will be listed here.

Abstract

Various pharmacologic agents have been used for perioperative BP control in pediatric patients, including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. Of the calcium antagonists, the majority of the clinical experience remains with the dihydropyridine nicardipine. Clevidipine is a short-acting, intravenous calcium channel antagonist of the dihydropyridine class. It undergoes rapid metabolism by non-specific blood and tissue esterases with a half-life of less than 1 minute. As a dihydropyridine, its cellular and end-organ effects parallel those of nicardipine. The clevidipine trials in the adult population have demonstrated efficacy in rapidly controlling BP in various clinical scenarios with a favorable adverse effect profile similar to nicardipine. Data from large clinical trials regarding the safety and efficacy of clevidipine in children is lacking. This manuscript aims to review the commonly used pharmacologic agents for perioperative BP control in children, discuss the role of calcium channel antagonists such as nicardipine, and outline the preliminary data regarding clevidipine in the pediatric population.

Citing Articles

Utilization of Sodium Nitroprusside as an Intestinal Permeation Enhancer for Lipophilic Drug Absorption Improvement in the Rat Proximal Intestine.

Kishimoto H, Miyazaki K, Tedzuka H, Ozawa R, Kobayashi H, Shirasaka Y Molecules. 2021; 26(21).

PMID: 34770805 PMC: 8587071. DOI: 10.3390/molecules26216396.

A Practical Guide to the Management of Severe Hypertension in Children.

Baracco R Paediatr Drugs. 2020; 22(1):13-20.

PMID: 31919683 DOI: 10.1007/s40272-019-00377-z.

Clevidipine: a review of its use for managing blood pressure in perioperative and intensive care settings.

Keating G Drugs. 2014; 74(16):1947-1960.

PMID: 25312594 DOI: 10.1007/s40265-014-0313-6.

Perioperative acute hypertension-role of Clevidipine butyrate.

Kurnutala L, Soghomonyan S, Bergese S Front Pharmacol. 2014; 5:197.

PMID: 25221513 PMC: 4145348. DOI: 10.3389/fphar.2014.00197.

Therapy of acute hypertension in hospitalized children and adolescents.

Webb T, Shatat I, Miyashita Y Curr Hypertens Rep. 2014; 16(4):425.

PMID: 24522943 PMC: 4129953. DOI: 10.1007/s11906-014-0425-0.

References

Bernard J, Passuti N, Pinaud M . Long-term hypotensive technique with nicardipine and nitroprusside during isoflurane anesthesia for spinal surgery. Anesth Analg. 1992; 75(2):179-85. DOI: 10.1213/00000539-199208000-00005. View

Velasquez-Jones L, Martini R . Sodium nitroprusside treatment of severe arterial hypertension in children. J Pediatr. 1975; 87(5):799-802. DOI: 10.1016/s0022-3476(75)80314-3. View

Lambert C, Hill J, Nichols W, FELDMAN R, Pepine C . Coronary and systemic hemodynamic effects of nicardipine. Am J Cardiol. 1985; 55(6):652-6. DOI: 10.1016/0002-9149(85)90130-4. View

Flynn J . Hypertension in the young: epidemiology, sequelae and therapy. Nephrol Dial Transplant. 2008; 24(2):370-5. DOI: 10.1093/ndt/gfn597. View

Rousseau M, Etienne J, Van Mechelen H, Veriter C, Pouleur H . Hemodynamic and cardiac effects of nicardipine in patients with coronary artery disease. J Cardiovasc Pharmacol. 1984; 6(5):833-9. DOI: 10.1097/00005344-198409000-00015. View

Tobias J, Sauder R, Hirshman C . Pulmonary reactivity to methacholine during beta-adrenergic blockade: propranolol versus esmolol. Anesthesiology. 1990; 73(1):132-6. DOI: 10.1097/00000542-199007000-00019. View

Hammer G, Verghese S, Drover D, Yaster M, Tobin J . Pharmacokinetics And Pharmacodynamics Of Fenoldopam Mesylate For Blood Pressure Control In Pediatric Patients. BMC Anesthesiol. 2008; 8:6. PMC: 2576052. DOI: 10.1186/1471-2253-8-6. View

Bunchman T, Lynch R, Wood E . Intravenously administered labetalol for treatment of hypertension in children. J Pediatr. 1992; 120(1):140-4. DOI: 10.1016/s0022-3476(05)80619-5. View

Schulz L, Elder Jr E, Jones K, Vijayan A, Johnson B, Medow J . Stability of Sodium Nitroprusside and Sodium Thiosulfate 1:10 Intravenous Admixture. Hosp Pharm. 2011; 45(10):779-784. PMC: 3102563. DOI: 10.1310/hpj4510-779. View

10.

Nordlander M, Sjoquist P, Ericsson H, Ryden L . Pharmacodynamic, pharmacokinetic and clinical effects of clevidipine, an ultrashort-acting calcium antagonist for rapid blood pressure control. Cardiovasc Drug Rev. 2004; 22(3):227-50. DOI: 10.1111/j.1527-3466.2004.tb00143.x. View

11.

Tobias J . Fenoldopam for controlled hypotension during spinal fusion in children and adolescents. Paediatr Anaesth. 2000; 10(3):261-6. DOI: 10.1046/j.1460-9592.2000.00502.x. View

12.

Tobias J . Nicardipine: applications in anesthesia practice. J Clin Anesth. 1995; 7(6):525-33. DOI: 10.1016/0952-8180(95)00093-w. View

13.

Wiest D, Garner S, Uber W, Sade R . Esmolol for the management of pediatric hypertension after cardiac operations. J Thorac Cardiovasc Surg. 1998; 115(4):890-7. DOI: 10.1016/S0022-5223(98)70371-X. View

14.

Hines R, Barash P . Infusion of sodium nitroprusside induces platelet dysfunction in vitro. Anesthesiology. 1989; 70(4):611-5. DOI: 10.1097/00000542-198904000-00010. View

15.

Lagerkranser M . Effects of nitroglycerin on intracranial pressure and cerebral blood flow. Acta Anaesthesiol Scand Suppl. 1992; 97:34-6. DOI: 10.1111/j.1399-6576.1992.tb03585.x. View

16.

Tobias J, Lowe S, Deshpande J . Nicardipine: perioperative applications in children. Paediatr Anaesth. 1995; 5(3):171-6. DOI: 10.1111/j.1460-9592.1995.tb00273.x. View

17.

Tobias J . Nicardipine to control mean arterial pressure after cardiothoracic surgery in infants and children. Am J Ther. 2001; 8(1):3-6. DOI: 10.1097/00045391-200101000-00002. View

18.

Moffett B, Price J . Evaluation of sodium nitroprusside toxicity in pediatric cardiac surgical patients. Ann Pharmacother. 2008; 42(11):1600-4. DOI: 10.1345/aph.1L192. View

19.

Strauser L, PRUITT R, Tobias J . Initial experience with fenoldopam in children. Am J Ther. 2001; 6(5):283-8. DOI: 10.1097/00045391-199909000-00007. View

20.

Moffett B, Mott A, Nelson D, Goldstein S, Jefferies J . Renal effects of fenoldopam in critically ill pediatric patients: A retrospective review. Pediatr Crit Care Med. 2008; 9(4):403-6. DOI: 10.1097/PCC.0b013e3181728c25. View