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Generic Procardia (Nifedipine 30mg)
- Denomination
Adalat, Procardia
- Active Substance
Nifedipine
- Indications for Use.
- Prevention of stenocardia attacks (including Prinzmetal’s angina);
- Arterial hypertension;
- Hypertrophic cardiomyopathy;
- Raynaud’s disease.
- Action
Nifedipine has got antianginal and antihypertensive potency.
Under the drug’s influence coronary vessels are dilated, coronary circulation is improved, oxygen consumption in myocardium is reduced. The drug also induces increase of a lumen of blood vessels, reduces general peripheral resistance of vessels and reduces arterial tension. Nifedipine does not exert an inhibitory effect on cardiac conduction system.
- Posology and Administration
The drug should be used strictly on a doctor’s order to avoid aggravations!
Posology and administration is to be determined individually in every case.
The starting dose is 1 tablet (10 mg) 2 times a day. If needed a dose may be increased up 2 tablets (20 mg) 4 times a day. The maximal daily dose is 80 mg.
- Counterindications
Arterial hypotension (systolic pressure is less than 90 mm of mercury column), tachycardia, collapse, insult to the brain, cardiogenic shock, decompensation heart failure, bad aortic stenosis, acute period of myocardial infarction (during the first 4 weeks), hypersensitivity to Nifedipine; childhood.
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Should Be Taken with Precautions, if…
The drug should be administered with caution to patients suffering from evidenced heart failure, severe disorders of brain circulation, diabetes, and malign hypertension. With caution it should be administered to patients with compromised function of liver and kidney. When there is acute treatment cessation and stenocardia - it may emerge progression of “withdrawal” syndrome, in aassociation with it the treatment should be ceased gradually. During Nifedipine therapy one must refrain from alcohol consumption.
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Interface with Other Medications
On the matter of parallel administration of another drug during Nifedipine therapy see your attending doctor.
- Overdosing
Symptoms: excessive drop of arterial tension; if a big quantity of tablets have been taken there may be tachycardia, bradycardia, arrhythmia, nausea, vomiting, weakness, skin redness, dizziness, drowsiness, retardation, disorder of color sensation, convulsions, loss of consciousness.
- Side Effects
In the beginning of the treatment there may be headaches, dizziness, apathy, drowsiness, drop of arterial tension, heartbeat, pains in the stomach, indigestion, swelling of gums (after a longer use), allergic rash, pricky and numbness sensation in the limbs, edema of lower limbs, retrosternal pains, enhancement of stenocardia attacks, pains in muscles, disturbance of vision, disturbance of heart rhythm, breast pains. Very seldom there are noticed progression of arthritis (mainly of knee joint), elevation of appetite and/or of the body weight.
- Pregnancy and Lactation
The drug should not be used in pregnancy and breast-feeding.
- Driving
The drug should be administered with caution to drivers of vehicles and operators of machinery, as while Nifedipine therapy there may be retardation of psychic and motion reactions and disorders of attention concentration.
CONGENITAL HEART DISORDERS: TETRALOGY OF FALLOT AND PULMONARY STENOSIS
A condition which can cause cyanotic congenital heart disease (as the 'blue baby' syndrome is technically known) is the Tetralogy of Fallot. This condition, which derives its name from Etienne-Louis-Arthur Fallot, who first described it in 1880, is for some reason much more common in boys than in girls. Here again the blueness is due to the reversal of a shunt between the right and left ventricles, causing deoxygenated blood to circulate. This reversal is not, however, caused by changes in the pulmonary system's resistance but is due to the resistance posed by the narrowing and obstruction of the outflow of the right ventricle. Dr. Fallot thought that there were four congenital defects involved, hence the term 'Tetralogy':
1. An opening between the ventricles - a ventricular septal defect.
2. A blocked or stenosed pulmonary valve.
3. An aorta that emerges from both ventricles instead of just the left ventricle.
4. An enlargement of the right ventricle.
In fact, the second two defects develop later as a result of the ventricular septal defect and the pulmonary valve defect. If these latter conditions are treated, the enlargement of the right ventricle and the distortion of the position of the aorta rectify themselves.
The severity of the condition, which will determine the symptoms of the patient and the degree of cyanosis (blueness), is itself determined by the degree of the obstruction to the outflow from the right ventricle to the lungs caused by one or a combination of the reasons mentioned in this context earlier. If the obstruction is mild, little or no blueness will show - this is known as 'acyanotic tetralogy'. If the obstruction is severe, however, the child will be very incapacitated: without treatment, suet infants are prone to convulsions and bouts о unconsciousness during feeding or crying, their growth is impaired, and the expected milestones of normal development are delayed. Moreover, these children are susceptible to infections, suet as bacterial endocarditis. Yet another complication is that, because the blood is inadequately oxygenated, it tries to make up for its own deficiency by manufacturing more than its usual quantity of red cells; as a result, it becomes very thick and viscous, and this in turn can lead to problems with blocked arteries and veins, especially in the brain.
Left to itself, the Tetralogy of Fallot is a desperately unkind condition. Without drastic treatment, nine out often 'blue babies' would die before the age of twenty-five, having struggled through years of considerable disability and discomfort. So the arguments are very much in favour of surgery, despite the risks attendant on any operation of this magnitude.
Correcting the Tetralogy of Fallot
Correcting the condition basically involves first closing the ventricular septal defect and then relieving the obstruction to the outflow of the right ventricle. In very severe cases, relieving the obstruction may entail cutting out any overgrowth of muscle, opening up the narrowed valve, and enlarging the underdeveloped area with a gusset.
At what age should a complete correction be performed? Assuming that there is adequate development of the right ventricular outflow tract and pulmonary arteries, a complete correction can be done at any age. If there is inadequate development and reconstruction is needed, then the child is tided over by use of a palliative procedure until the age of two to three years. There are various palliative procedures, but all are designed to increase blood-flow to the lungs and thereby improve oxygenation. One way is to create a shunt between a systemic artery and the pulmonary artery; another is partially to relieve the obstruction to the right ventricular outflow by, for example, pulmonary valvotomy (improving the functioning of the pulmonary valve).
Correcting the Tetralogy of Fallot is one of the most rewarding operations a surgeon can do. A sickly, blue child is transformed within a matter of hours into a healthy, pink, lively individual. The effect seems miraculous.
*19/353/5*
CARDIO & BLOOD
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