http://stroke.ahajournals.org/content/22/4/437.short
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 (less than or equal to 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 less than or equal to 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.
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