The Role of a Single Dose of Sublingual Nifedipine in Managing Hypertensive Emergencies in the Patients who Undergo Haemodialysis.

INTRODUCTION The hypertensive emergencies in haemodialysis require immediate therapy, usually by parenteral drug administration; however, sublingual medications may have a potential in this special condition. METHODS A prospective, non randomized, case control study was carried out to know the effectiveness and the safety of a single dose of 5mg Nifedipine (sublingual) in this subset of patients. About 100 patients were studied, who were on maintained haemodialysis and were having high Blood Pressure (BP) during the haemodialysis. The patients were monitored for about 5 hours. RESULTS The patients who had chronic renal failure, who were maintained on regular haemodialysis, who had high systolic and diastolic blood pressure of >220 (systolic) and >125 (diastolic) respectively, were subjected to the study. These patients were of the 20-70 years age group, who visited our hospital between January 2010 to January 2011. Out of the 100 patients 30% were females and the rest (70%) were males. A single dose of nifedipine (5 mg by the sublingual route) was prescribed to determine its effectiveness and safety in the treatment of hypertensive emergencies during haemodialysis. The side effects of the drug were closely monitored. The blood pressure and the heart rate were measured continuously up to 280 min post-dose. The response rates were 90 % for nifedipine. The significant hypotensive effects of sublingual nifedipine occurred at 10 min, and a maximum reduction occurred after 30 mins and it continued up to 120 min. CONCLUSIONS We concluded that sublingual nifedipine was effective and that it seemed to have less side effects. It may be an excellent drug in the urgent treatment of hypertensive emergencies in haemodialysis.