De Cock, Pieter

de Jaeger, Annik

Raes, Ann

Robays, Hugo

Van Bortel, Lucas

Vande Walle, Johan

English

Ghent University Academic Bibliography

   Disclaimer: The abstract featured has been produced using author-supplied copy. The publishers assume no responsibility for any injury and/or damage to persons or property as a matter of product liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. In view of rapid advances in medical sciences, independent verification of diagnoses and drug doses is recommended. ESCP International Office 300, Avenue de Tervueren 1150 Brussels, Belgium Tel: 32-2 743 1542 Fax: 32-2 743 1550 info@escpweb.org, http://www.escpweb.org 7th ESCP Spring Conference in Clinical Pharmacy, 16-19 May 2007, Edinburgh, UK  Poster Presentation  PT-149   Safety of short-acting nifedipine in children : a literature review    Pieter De Cock1, Luc Van Bortel2, Ann Raes3, Johan Vandewalle3, Annick De Jaeger4, Hugo Robays1 1Pharmacy Dpt., 2Clinical Pharmacology Dpt., 3Paediatric Nephrology Dpt., 4Paediatric Intensive Care Dpt., University Hospital, Ghent, Belgium   Background and Objective: Short-acting nifedipine has been abandoned for treatment of hypertensive crises in adults as a result of significant adverse events. This literature review will assess the safety of short-acting (SA) nifedipine in paediatrics.   Design: Literature review   Setting: Department of Paediatrics   Main Outcome Measures: Guideline for safe use   Results: A Pubmed search revealed three large retrospective series specifically addressing the safety of use of SA nifedipine in children.  First retrospective series reported that a ≥ 25 % precipitous reduction in mean arterial pressure (MAP) was observed in 35 % of given doses. MAP reduction significantly correlated with nifedipine dose adjusted for weight. A dose of 0.25 mg/kg or less did not lead to precipitous MAP reduction. No patients experienced cardiovascular or central nervous system side effects.  A similar chart review reported a mean blood pressure reduction of 17 % for systolic blood pressure and 28 % for diastolic blood pressure. Adverse drug events occurred in 9.6 % of patients and included neurological events, symptomatic hypotension and oxygen desaturation. In most neurological events and all patients with symptomatic hypotension a blood pressure reduction of > 20 % was observed. 33 % of neurological events occurred in patients with acute central nervous system (CNS) injury.  5.1 % minor adverse events probably related to SA nifedipine administration were recorded in a third review and mainly included edema, nausea and vomiting and gastro-intestinal pain. A serious adverse event of blood pressure reduction > 40 % occurred in two patients but neither was symptomatic and all recovered spontaneously within 2 h.  Conclusions: Based on available literature, a consensus in our hospital was gathered for continued use of short-acting nifedipine in hospitalized children, except in those with acute CNS damage. However, it should only be used on wards with extensive patient monitoring and at a dose below 0.25 mg/kg.   Keywords: nifedipine ; safety ; children   

Safety of short-acting nifedipine in children: a literature review

https://biblio.ugent.be/publication/540468/file/1136912.pdf

Safety of short-acting nifedipine in children: a literature review

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Ghent University Academic Bibliography