Effects of sublingual administration of nifedipine on arterial pressure, plasma renin activity, and glomerular filtration rate in essential hypertension

A Comparison of Safety and Efficacy of Sublingual Captopril with Sublingual Nifedipine in Hypertensive Crisis

Sublingual nifedipine is commonly used in hypertensive crisis, however, it may result in several adverse effects such as reflex tachycardia, headache, and flushing. Research is continuing to find a new drug that has the same efficiency and fewer side effects. Sublingual captopril, a new preparation of angiotensin-converting enzyme inhibitor, lowers blood pressure. It is not known whether it is effective in these emergent clinical settings. Therefore we designed a randomized, double-blind study to compare the efficacy and safety of those two drugs in hypertensive crisis. Eighty patients (32 male and 48 female) with hypertensive crisis were included in the study; their mean age was 43.4 +/- 7.9 years. Nifedipine 10 mg was given sublingually to 34 and captopril 25 mg to 46 patients randomly. There was no difference between the two drugs with respect to their antihypertensive effect. Heart rate significantly dropped (p < 0.01 and p < 0.001) in the patients taking captopril, but no changes were observed in the patients taking nifedipine. Twenty-three of 34 patients taking nifedipine encountered adverse effects. Adverse effects were observed in only three patients taking captopril (p < 0.001). Sublingual captopril is as effective as and has less side effects than sublingual nifedipine. Because sublingual captopril has fewer side effects, it may be safer than nifedipine in the treatment of hypertensive crisis.http://link.springer-ny.com/link/service/journals/00547/bibs/8n3p147.html

Medication delivery in the short-bowel syndrome

Technologic advances such as total parenteral nutrition have prolonged the lives of individuals with short-bowel syndrome who previously would not have survived. However, the day-to-day management of these patients presents a significant challenge to those who take care of them. Providing medications on either an acute or chronic basis without the use of their central catheters is a difficult clinical problem. This article reviews the approach and methods of treating short-bowel patients on the basis of their individual circumstances and physiology.