1. Prophylaxis and handling of cerebral vasospasm hinder aneursymal subarachnoid haemorrhage
PRESENTATION AND ADMINISTRATION: IV: Nimotop steeped liquor solution: 10mg nimodipine / 50ml
Use and nothing else infusion pumps with polyethylene (PE) infusing tubing, polypropylene (PP) syringes and polyethylene or polypropylene extensions, taps and connectors. Do not use polyvinylchloride (PVC) macerating tubing as nimodipine is absorbed ~ the agency of the tubing. Administer nimodipine excellent. Give via a three-advance stopcock with a coinfusion of compatible IV liquid and gaseous in a ratio of 1:4 (nimodipine: coinfusion). For precedent, an infusion running at 10ml/hr requires a co-infusion of 40ml/hr. Compatible with the following IV fluids:
Protect from pane . Infusion solution is public notice sensitive. Do not appliance in direct light of heaven. Note: administration of nimodipine by way of a central cord is preferred at the same time that nimodipine causes thrombophlebitis whenever administered peripherally. If indispensable, the peripheral path can be used (be it so administration via this way is not licensed)
PO: Nimotop tablets 30mg (yellow)
DOSAGE: IV: Commence steeped liquor at 1mg/hr (5ml/hr) conducive to two hours and afterwards increase to 2mg/hr (10ml/ hr) whether tolerated. For patients who are incompetent to tolerate introduction at 1mg/hr, break the ice infusion at 0.5mg/hr (2.5ml/hr)
Weaning from IV to verbal therapy: Commence regular nuncupative therapy (see in the under world). After the foremost dose of nimodipine is given, master infusion by 1 mL each hour for 5 hours, for this reason cease infusion. If the patient becomes hypotensive after spoken nimodipine is given, end the infusion closely. Observe for neurological degradation. If the submissive does deteriorate neurologically, stop weaning off IV nimodipine and return to full IV therapy.
PO: 60mg 4 frequently for 21 days; whether or not not tolerated appropriate to hypotension, try a reduced prescribed portion of 30mg 4 every hour.
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY: Dose being of the kind which in normal renal performance
DOSAGE IN PAEDIATRICS: 10-15mcg/kg/hr IV in the place of 2 hours soon afterward 10-45mcg/kg/hr
CLINICAL PHARMACOLOGY: Nimodipine is a calcium way blocker
CONTRAINDICATIONS: 1. Hypersensitivity to nimodipine Nimodipine WARNINGS Nimodipine be able to cause hypotension. If hypertensive therapy is existence pursued or the calm develops significant hypotension for the time of nimodipine treatment, the drench should be reduced or nimodipine should have existence withheld.
PRECAUTIONS General The metabolism of nimodipine is decreased in patients with impaired hepatic duty. Such patients should be under the necessity their blood difficulty and pulse be~ monitored closely and should have existence given a reduce dose. (usually 50% of legitimate dose)
IMPORTANT DRUG INTERACTIONS FOR THE ICU: The peril of hypotension increases through concomitant administration of other antihypertensive drugs.
Hypotension, tachycardia, bradycardia, deranged liver duty tests, diarrhoea, Headache
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