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Early Treatment of Ischemic Stroke with a Calcium Antagonist
Stroke 22:437-441, Rosenbaum,D.,et al, 1991
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Article Abstract
We performed a feasibility and safety study(phase II)of nicardipine,a calcium antagonist,in 57 patients.The objectives of the study were to begin therapy as early as possible(=12 hours)after the onset of ischemic stroke and to administer as high a dose as possible.All patients received an intravenous infusion of nicardipine for 72 hours,starting with a dose of 3 mg/hr and increasing to a maximum dose of 7 mg/hr.Upward titration of the dose was limited by a 10%decrease in blood pressure or a 20 beats/min increase in pulse.Intravenous therapy was followed by 30 days of oral therapy.The mean+/-SD interval from onset of stroke to commencement of therapy was 9.1+/-5.4 hours.Adverse reactions consisted primarily of hypotension requiring discontinuation of therapy in four patients.Score on a graded neurologic examination increased from 41/100 at baseline to 64/ 100 at 3 months for the 41 patients completing follow-up.There was no correlation between the dose of nicardipine administered and outcome,but the 11 patients starting therapy=6 hours after onset did better than those starting therapy 6-12 hours after onset.Further study of very early therapy with nicardipine is justified.
Related Tags
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adverse drug reaction
calcium antagonist
cerebrovascular accident
cerebrovascular accident,acute management of
hypotension,systemic
neuroprotective agents
nicardipine
treatment of neurologic disorder
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