Clevidipine: A Unique Agent for the Critical Care Practitioner

Clevidipine is a new third generation intravenous dihydropyridine calcium channel blocker. It is a specific arterial vasodilator developed for the acute reduction and control of arterial blood pressure in the perioperative period. This drug has an extremely short half life and is rapidly metabolized by tissue and plasma esterases. Clevidipine is a potent arterial vasodilator with very little or no effect of the myocardial contractility and venous capacitance and also minimal side effects. Clevidipine can also theoretically help to protect against organ reperfusion injury. Theoretically, this effect resides in the capacity of this agent to debilitate oxygen free radical-mediated toxicity, cell calcium overload and augment endothelial nitric oxide bioavailability through antioxidative actions. As a result it may diminish the severity of low flow myocardial ischemia and preserve the coronary endothelial function thereby reducing the infarct size. Due to all the characteristics of this parenteral agent it promises to be the drug of choice for the critical care practitioner for the strict control of blood pressure in different clinical scenarios.