New drugs: Clevidipine butyrate, difluprednate, and tetrabenazine

摘要

Clevidipine butyrate {Cleviprex-The Medicines Company) is a dihydropyri-dine calcium channel blocker (CCB) that is administered intravenously. It is most closely related structurally to felodipine (e.g;, Plendil), but its use and properties can best be compared with those of nicardipine (Cardene IV), as these are the only two dihydropyridine CCBs that are available for intravenous use. Nicardipine is also available in a capsule formulation (Cardene SR) for oral use.Clevidipine is indicated for intravenous use for reducing blood pressure when oral therapy is not feasible or not desirable. It is most useful for the urgent treatment of hypertension (e.g., peri-operative hypertension, severe hypertension). In addition to clevidipine and nicardipine, other drugs that are administered intravenously for hypertensive emergencies include sodium nitroprus-side, nitroglycerin, esmolol (Brevibloc), labetalol (Trandate), phentolamine, hy--dralazine, and fenoldopam (Corlopam). Both clevidipine and nicardipine have arapid onset of action (usually 2-4 min); however, clevidipine has a much shorter duration of action (usually <15 min) than nicardipine (at least 3 h). The short duration of action of the new drug permits closer monitoring and adjustment of the blood pressure-lowering response than is possible with nicardipine and other longer-acting agents.