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Joseph E Cruz, Zachariah Thomas, David Lee, David M Moskowitz, Jeff Nemeth
BACKGROUND: Generic price inflation has resulted in rising acquisition costs for sodium nitroprusside (SNP), an agent historically described as the drug of choice for the treatment of perioperative hypertension in cardiac surgery. PURPOSE: To describe the implementation and cost avoidance achieved by utilizing clevidipine as an alternative to SNP in cardiac surgery patients at a 520-bed community teaching hospital that performs more than 300 cardiac surgeries each year...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Nicoleta Stoicea, Nicholas Joseph, Sergio D Bergese
No abstract text is available yet for this article.
August 2016: EBioMedicine
Natalie A Freiberger, Katie B Tellor, Alison M Stevens
OBJECTIVE: To evaluate the efficacy and safety of clevidipine (CLV) versus sodium nitroprusside (SNP) for the treatment of hypertension (HTN) in postoperative cardiac surgery patients at a community hospital. METHODS: This single-center, retrospective, cohort study included cardiac surgery patients treated with CLV or SNP for postoperative systolic blood pressure (SBP) control. The primary efficacy outcome was defined as the mean number of times the SBP rose above 140 mm Hg...
June 2016: Hospital Pharmacy
Gerhard P Dahl, Gregory E Conner, Feng Qiu, Junjie Wang, Edward Spindler, Jason A Campagna, H Peter Larsson
UNLABELLED: Clevidipine, a dihydropyridine (DHP) analogue, lowers blood pressure (BP) by inhibiting l-type calcium channels (CaV1.2; gene CACNA1C) predominantly located in vascular smooth muscle (VSM). However, clinical observations suggest that clevidipine acts by a more complex mechanism. Clevidipine more potently reduces pulmonary vascular resistance (PVR) than systemic vascular resistance and its spectrum of effects on PVR are not shared by other DHPs. Clevidipine has potent spasmolytic effects in peripheral arteries at doses that are sub-clinical for BP lowering and, in hypertensive acute heart failure, clevidipine, but not other DHPs, provides dyspnea relief, partially independent of BP reduction...
August 2016: EBioMedicine
Angel Espinosa, Javier Ripollés-Melchor, Rubén Casans-Francés, Alfredo Abad-Gurumeta, Sergio D Bergese, Alix Zuleta-Alarcon, Francisco López-Timoneda, José María Calvo-Vecino
BACKGROUND: Clevidipine is an ultrashort-acting drug for rapid reduction of blood pressure by selectively acting on the L-type Ca2+ channels on arteriolar smooth muscle. The drug's ultrashort action in reducing the blood pressure is due to its rapid hydrolysis by blood and extravascular tissue esterases, which does not depend on hepato-renal metabolism and excretion. An analysis of the perioperative management of blood pressure should be considered to compare with other intravenous antihypertensive agents...
2016: PloS One
Abhishek Singh, Saïd Laribi, John R Teerlink, Alexandre Mebazaa
Millions of patients worldwide are admitted for acute heart failure (AHF) each year and physicians caring for these patients are confronted with the short-term challenges of reducing symptoms while preventing end organ dysfunction without causing additional harm, and the intermediate-term challenges of improving clinical outcomes such as hospital readmission and survival. There are limited data demonstrating the efficacy of any currently available therapies for AHF to meet these goals. After diuretics, vasodilators are the most common intravenous therapy for AHF, but neither nitrates, nitroprusside, nor nesiritide have robust evidence supporting their ability to provide meaningful effects on clinical outcomes, except perhaps early symptom improvement...
February 4, 2016: European Heart Journal
Hui-hui Wei, Yuan Gu, Yan-ping Liu, Guang-li Wei, Yong Chen, Chang-xiao Liu, Duan-yun Si
A rapid, sensitive and simple liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the simultaneous determination of clevidipine butyrate and its primary metabolite clevidipine acid in dog blood. After one-step protein precipitation with methanol, the chromatographic separation was carried out on an Ecosil C18 column (150 mm x 4.6 mm, 5 µm) with a gradient mobile phase consisting of methanol and 5 mmol · L(-1) ammonium formate. A chromatographic total run time of 13...
October 2015: Yao Xue Xue Bao, Acta Pharmaceutica Sinica
Jacqueline Finger, Lisa Kurczewski, Gretchen Brophy
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Ola Elnadoury, Teena Abraham, Joseph Samide, Meggie Yuen, Erin Oh, Nasser Saad, Francesco Ciummo, Bashar Fahoum
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Yuxia Zhou, Fan Zhou, Fei Yan, Feng Yang, Yuxian Yao, Qiaogen Zou
Eleven potential impurities, including process-related compounds and degradation products, have been analyzed by comprehensive studies on the manufacturing process of clevidipine butyrate. Possible formation mechanisms could also be devised. MS and NMR techniques have been used for the structural characterization of three previously unreported impurities (Imp-3, Imp-5 and Imp-11). To separate and quantify the potential impurities in a simultaneous fashion, an efficient and advanced RP-HPLC method has been developed...
March 2016: Journal of Chromatographic Science
Brian P Lemkuil, Brian T Gierl, Piyush M Patel, Matthew L Pearn, Liem C Nguyen, Anushirvan Minokadeh, John C Drummond
BACKGROUND: Clevidipine is a short acting, esterase metabolized, calcium channel antagonist administered as a continuous infusion for control of hypertension. Its profile allows for rapid titration and may be uniquely suited to achieving tight hemodynamic targets in neurosurgical and neurocritical care patients. The present study was designed to investigate the effect of clevidipine infusion on cerebral blood flow and cerebral CO2 responsiveness as measured by cerebral blood flow velocity (CBFV) using transcranial Doppler...
October 2016: Journal of Neurosurgical Anesthesiology
Peng Cao, Gao Li, Ling Huang, Shouwei Zhao, Yang Hu, Lixia Qin, Lihui Qiu, Wenwen Zhu, Luqin Si, Jiangeng Huang
BACKGROUND: Clevidipine is an ester-containing antihypertensive agent that undergoes rapid hydrolysis in blood. A reliable stabilizer cocktail containing citric acid and ascorbic acid was established and the LC-MS/MS method was validated for simultaneous determination of clevidipine and its major metabolite in beagle dog whole blood. RESULTS: The stabilizer could nearly completely inhibit the esterase activity. Both analytes were extracted from whole blood by toluene and detected by MS/MS in positive ESI mode...
2015: Bioanalysis
(no author information available yet)
Beware of hypersensitivity reactions to the lipid emulsion.
October 2014: Prescrire International
Hiromi Kako, Andrew Gable, David Martin, Allan Beebe, Arlyne Thung, Walter Samora, Jan Klamar, Tarun Bhalla, Joseph D Tobias
OBJECTIVES: Controlled hypotension is one means to limit or avoid the need for allogeneic blood products. Clevidipine is a short-acting, intravenous calcium channel antagonist with a half-life of 1 to 3 minutes due to rapid metabolism by non-specific blood and tissue esterases. To date, there are no prospective evaluations with clevidipine in the pediatric population. We prospectively evaluated the dosing requirements, efficacy, and safety of clevidipine for ontrolled hypotension during spinal surgery for neuromuscular scoliosis in the pediatric population...
January 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Ying Zhou, Xiao-meng He, Hu-qun Li, Yang Ni, Ming-zhen Xu, Hui Chen, Wei-yong Li
The purpose of the current study was to examine the pharmacokinetic profiles and tissue distribution of clevidipine, an ultra-short-acting calcium antagonist in Beagle dogs and Sprague-Dawley rats, respectively. The pharmacokinetics and biodistribution of its primary metabolite H152/81 were also evaluated. Dogs received intravenous infusion of clevidipine at a dose rate of 17 μg/(kg·min), and rats were given intravenous administration of clevidipine at a dose of 5 mg/kg. Dog plasma and rat tissues were collected and assayed by HPLC-MS/MS...
December 2014: Journal of Huazhong University of Science and Technology. Medical Sciences
Yuxia Zhou, Qiaogen Zou, Lili Sun, Ping Wei, Pingkai Ouyang
Dispersive liquid-liquid microextraction based on the solidification of a floating organic droplet combined with high-performance liquid chromatography with ultraviolet detection (HPLC-UV) was developed for the determination of clevidipine and its primary metabolite in Sprague-Dawley rat plasma samples. During the extraction procedure, to facilitate an efficient procedure, the plasma protein was precipitated first by using a mixture of a zinc sulfate solution and acetonitrile. Several extraction parameters were carefully evaluated and optimized, including the type and volume of the extraction solvent, salt effect, pH and extraction time...
May 2015: Journal of Chromatographic Science
Gillian M Keating
The ultrashort-acting dihydropyridine calcium channel antagonist clevidipine (Cleviprex(®)) has a rapid onset and offset of effect and reduces blood pressure (BP) by decreasing arteriolar resistance without affecting venous capacitance vessels. This article reviews the clinical efficacy and tolerability of intravenous clevidipine when used to manage BP in perioperative and intensive care settings, as well as summarizing its pharmacological properties. Intravenous clevidipine effectively treated preoperative and postoperative hypertension in patients undergoing cardiac surgery, according to the results of the randomized, multicentre, double-blind, phase III ESCAPE-1 and ESCAPE-2 trials...
October 2014: Drugs
Hélia Beatriz Nunes de Araujo, Antônio Aurélio de Paiva Fagundes, Luiz Roberto Leite, Alberto Gomes Taques Fonseca
Hypertensive emergency, is the most severe presentation of arterial hypertension, having high morbidity-mortality. Clevidipine is a calcium channel blocker. Its pharmacokinetics is favorable to use for hypertensive emergencies, rendering this drug a promising alternative to the restricted therapeutic armamentarium available both in the emergency room and intensive care unit. In this review we describe the pharmacodynamics, pharmacokinetics and clinical trials evaluating Clevidipine in emergency situations, comparing this drug to other traditionally used drugs in this condition...
March 2010: Revista Brasileira de Terapia Intensiva
Huihui Wei, Yuan Gu, Yanping Liu, Yong Chen, Changxiao Liu, Duanyun Si
Clevidipine, a vascular selective calcium channel antagonist of the dihydropyridine class, is rapidly metabolized by ester hydrolysis because of incorporation of an ester linkage into the drug molecule. To characterize its pharmacokinetic profiles in dogs, a simple, rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for quantitation of clevidipine in dog blood. After one-step protein precipitation with methanol, the chromatographic separation was carried out on an Ecosil C18 column (150mm×4...
November 15, 2014: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Solomon Aronson, Joseph F Dasta, Jerrold H Levy, Philip D Lumb, Manuel Fontes, Yamei Wang, Tracy A Crothers, Katherine A Sulham, Marco S Navetta
OBJECTIVE: To examine the impact of intravenous antihypertensive selection on hospital health resource utilization using data from the Evaluation of CLevidipine In the Perioperative Treatment of Hypertension Assessing Safety Events (ECLIPSE) trials. METHODS: Analysis of ECLIPSE trial data comparing clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine and unit costs based on the Premier Hospital database to assess surgery duration, time to extubation, and length of stay (LOS) with the associated cost...
August 2014: Hospital Practice (Minneapolis)
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