Influence of cardiopulmonary resuscitation on plasma concentrations of nimodipine in the dog.

The influence of cardiopulmonary resuscitation on the plasma concentrations of nimodipine in the anaesthetized dog has been examined. Nimodipine was given as a bolus injection followed by a maintenance infusion. When, during the maintenance infusion, the dogs were subjected to cardiac arrest followed by external cardiac massage combined with artificial ventilation (basic life support), a fast and almost threefold increase in the steady-state plasma concentrations of nimodipine was observed. When the maintenance infusion of nimodipine was stopped immediately before cardiac arrest and basic life support, the nimodipine concentrations decreased. These results indicate that during basic life support, there is a decreased transfer of infused nimodipine from plasma to the tissues. This is also supported by the fact that for antipyrine, a drug with a smaller volume of distribution than nimodipine, the increase in plasma concentrations when infused during cardiac arrest and basic life support, was much smaller. When nimodipine was started after restoration of the spontaneous circulation (advanced life support) in dogs that had been subjected to cardiac arrest and basic life support, the plasma concentrations were not significantly higher than in control dogs. It can be concluded that the fate of nimodipine is markedly altered during basic life support but not in the period following restoration of spontaneous circulation.