The Prognostic Significance of the Concentration of Nimodipine in the CSF and Plasma in Subarachnoid Hemorrhage
A major cause of mortality and morbidity in subarachnoid hemorrhage of aneurysmal origin is vasospasm. An analysis of the available placebo-controlled double-blind and open prospective studies provides statistically significant evidence that the calcium antagonist nimodipine can reduce the frequency of these spasm-induced delayed ischemic neurological deficits. However, very divergent percentages are reported in the various studies, ranging in the randomized studies from 1% with intravenous administration to 2%–16% with oral dosage [1–6,8–11]. It is unclear what intraindividual and interindividual variations in the plasma and CSF concentration are present or are to be expected in medication with nimodipine. A high level of protein binding and the interaction with other drugs are known with regard to pharmacokinetics .
KeywordsStarch Albumin Dexamethasone Neurol Hunt
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- 5.Gilsbach J (1988) Nimodipine in the prevention of ischaemic deficits after aneurysmal subarachnoid haemorrhage. Acta Neurochir (Wien) [Suppl] 54:41–50Google Scholar
- 7.Härders A, Gilsbach J (1988) Haemodynamic effectiveness of nimodipine on spastic brain vessels after subarachnoid haemorrhage evaluated by the transcranial Doppler method. Acta Neurochir (Wien) 45:21–28Google Scholar
- 8.Kazner E, Sprung C, Adelt D et al. (1985) Clinical experience with nimodipine in the prophylaxis of neurological deficits after subarachnoid haemorrhage. Neurochirurgia 18:110–113Google Scholar
- 10.Öhman J, Heiskanen O (1987) The effect of nimodipine on cerebrovascular spasm after subarachnoid haemorrhage — a randomized, double-blind study, presented at the 2nd World Congress of Neuroscience, Budapest, Hungary, August 16–21, 1987Google Scholar
- 12.Raemsch KH, Graefe KH, Sommer J (1985) Pharmacokinetics and metabolism of nimodipine. In: Betz E, Deck K, Hoffmeister F (eds) Nimodipine, pharmacological and clinical properties. Schattauer, Stuttgart, pp 147–159Google Scholar
- 13.Scriabine A, Battye R, Hoffmeister F et al. (1985) Nimodipine. In: Scriabine A (ed) New drugs annual: cardiovascular drugs, vol 3. Raven, New York, pp 197–218Google Scholar