NIMODIPINE
It is a 1/4 dihydropyridine, calcium channel blocker. Being lipid soluble it easily crosses the blood brain barrier & has a preferential ffect on arterioles with a diameter d be possible to prevent or reverse delayed vasospasm of cerebral arteries,& the resultant effects on neurological outcome & survival.The Calcium antagonist blocks the calcium channels & influx of extracellular calcium to cerebrovascular smooth muscle cells preventing the entry of calcium into neurons & creating a neuronal protective action.Prevention of ischaemic neurological deficits following subarachnoid haemorrhage.
60 mg 4 hrly starting wihin 4 days of subarachnoid haemorrhage, continue for 3 wks.
Pregnancy, nursing mothers.
Renal dysfunction & hepatic impairment. Raised intracranial pressure. Cerebral oedema. Monitor blood pressure. Paediatrics: Safety not established. Pregnancy & Lactation Should not be used. Elderly: Use with caution.
Headache, flushing, hypotension. Change in heart rate, nausea.
Other calcium channel blockers increeases its effects. Phenytoin and caffeine increases the toxicity of these drugs due to decreased hepatic metabolism.
