Pediatric emergency medicine trisk 0760 0760

Nicardipine is a second-generation dihydropyridine calcium channel blocker that
prevents vascular smooth muscle contraction, resulting in a reduction in
peripheral vascular resistance without compromising cardiac output. Its onset of
action within 1 to 2 minutes of administration and short elimination half-life
make it relatively easy to titrate. Nicardipine is the preferred agent for the
treatment of hypertensive emergencies at many institutions because of its safety
profile, ability to produce a rapid effect, and low risk for causing hypotension.
Recommended dosing is 1 to 3 μg/kg/min by continuous infusion. Hypotension,
though uncommon, can be reversed by the administration of calcium. Nicardipine
should be avoided in patients with increased intracranial pressure. Reflex
tachycardia, usually clinically insignificant, and phlebitis are known adverse
effects.