Nurses Compass
Drug Guide
Clevidipine
Classification
Therapeutic: Antihypertensive
Pharmacological: Calcium Channel Blocker (Dihydropyridine)
FDA Approved Indications
- Management of refractory hypertension when oral therapy is not feasible or not preferred.
Mechanism of Action
Clevidipine inhibits calcium ions from entering vascular smooth muscle and cardiac muscle cells, resulting in decreased peripheral vascular resistance and blood pressure.
Dosage and Administration
Adult: Start with 1-2 mg/hour IV infusion; titrate every 90 seconds to achieve desired blood pressure, typically up to 16 mg/hour.
Pediatric: Not approved for pediatric use.
Geriatric: Use with caution, start at lower end of dosing range due to increased sensitivity.
Renal Impairment: No specific dosage adjustment recommended.
Hepatic Impairment: Use with caution; no specific adjustments established.
Pharmacokinetics
Absorption: Rapid onset due to IV administration.
Distribution: Widely distributed; negligible protein binding.
Metabolism: Rapid hydrolysis by blood and tissue esterases.
Excretion: Metabolites excreted primarily in the urine.
Half Life: Approximately 2-3 minutes.
Contraindications
- Allergy to ingredients.
Precautions
- Use with caution in patients with dissecting aortic aneurysm, unstable angina, or recent MI.
- Monitor for hypotension and reflex tachycardia.
Adverse Reactions - Common
- Headache (Common)
- Nausea (Common)
- Hypotension (Common)
Adverse Reactions - Serious
- Rebound hypertension upon abrupt cessation (Serious)
- Reflex tachycardia (Serious)
Drug-Drug Interactions
- Other antihypertensives, increasing risk of hypotension.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure closely during infusion.
Diagnoses:
- Risk for hypotension.
- Risk for decreased tissue perfusion.
Implementation: Administer via infusion pump, titrate carefully, monitor vital signs.
Evaluation: Achieve target blood pressure without inducing hypotension or adverse effects.
Patient/Family Teaching
- Report symptoms of excessive hypotension or dizziness.
- Follow instructions for infusion site care.
Special Considerations
Black Box Warnings:
- Use only in settings where blood pressure can be closely monitored.
- Abrupt discontinuation may cause rebound hypertension.
Genetic Factors: None specified.
Lab Test Interference: No known interference.
Overdose Management
Signs/Symptoms: Severe hypotension, reflex tachycardia, dizziness.
Treatment: Discontinue drug, provide supportive care, administer vasopressors if necessary.
Storage and Handling
Storage: Store at room temperature, protected from light.
Stability: Stable until expiration date when stored properly.