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Calcium Antagonists (Calcium Channel Blockers)

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Cardiac Drug Therapy

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

There are important, subtle differences among the available calcium antagonists that may affect the choice in treating individual patients. First generation dihydropyridines are short-acting agents that include felodipine, isradipine, nifedipine, and nitrendipine. These rapid-acting vasodilators are powerful antihypertensive agents, but their fast onset of action results in marked vasodilation that causes reflex stimulation of the sympathetic nervous system and hemodynamic adverse effects that include increased heart rate, increased cardiac workload, and an increased incidence of heart failure in patients with left ventricular dysfunction. The short-acting formulations of dihydropyridines, verapamil, and diltiazem are no longer recommended.

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References

  • ACCOMPLISH, Jamerson K, Weber MA, Bakris GL, (for the ACCOMPLISH Trial Investigators), et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008;359:2417–28.

    Article  CAS  PubMed  Google Scholar 

  • Allen GS, Ahn HS, Preziosi TJ, et al. Cerebral arterial spasm: a controlled trial of nimodipine in patients with subarachnoid hemorrhage. N Engl J Med. 1983;308:619.

    Article  CAS  PubMed  Google Scholar 

  • Ballester E, Roca J, Rodriquez-Roisin R, et al. Effect of nifedipine hypoxemia occurring after metacholine challenge in asthma. Thorax. 1986;41:468.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Braunwald E. Mechanism of action of calcium-channel-blocking agents. N Engl J Med. 1982;307:1618.

    Article  CAS  PubMed  Google Scholar 

  • Choong CYP, Roubin GS, Shen WF, et al. Effects of nifedipine on arterial oxygenation at rest and during exercise in patients with stable angina. J Am Coll Cardiol. 1986;8:1461.

    Article  CAS  PubMed  Google Scholar 

  • Fleckenstein A. Specific pharmacology of calcium in myocardium, cardiac pacemakers and vascular smooth muscle. Annu Rev Pharmacol Toxicol. 1977;17:149.

    Article  CAS  PubMed  Google Scholar 

  • Gulamhusein S, Ko P, Klein GJ. Ventricular fibrillation following verapamil in the Wolff-Parkinson-White syndrome. Am Heart J. 1983;106:145.

    Article  CAS  PubMed  Google Scholar 

  • Krikler DM, Harris L, Rowland E. Calcium-channel blockers and beta blockers: advantages and disadvantages of combination therapy in chronic, stable angina pectoris. Am Heart J. 1982;104:702.

    Article  CAS  PubMed  Google Scholar 

  • Kuhlmann J. Effects of nifedipine and diltiazem on plasma levels and renal excretions of beta-acetyldigoxin. Clin Pharmacol Ther. 1985;37:150.

    Article  CAS  PubMed  Google Scholar 

  • Lee TH, Friedman PL, Goldman L, et al. Sinus arrest and hypotension with combined amiodarone-diltiazem therapy. Am Heart J. 1985;109:163.

    Article  CAS  PubMed  Google Scholar 

  • Lette J, Gagnon RM, Lemire TG, et al. Rebound of vasospastic angina after cessation of long-term treatment with nifedipine. Can Med Assoc J. 1984;130:1169.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Matterson BJ, Reda DJ, Cushman WC, et al. Single-drug therapy for hypertension in men: a comparison of six hypertensive agents with placebo. N Engl J Med. 1993;328:914.

    Article  Google Scholar 

  • Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med. 1989;319:385.

    Article  Google Scholar 

  • PRAISE, Packer M, O’Connor CM, Ghali JK, et al. Effect of amlodipine on morbidity and mortality in severe chronic heart failure: for the prospective randomised amlodipine survival evaluation study group. N Engl J Med. 1996;335:1107.

    Article  CAS  PubMed  Google Scholar 

  • Scheidt S, Frishman WF, Packer M, et al. Long term effectiveness of verapamil in stable and unstable angina pectoris: one year follow-up of patients treated in placebo-controlled, double-blind randomized clinical trial. Am J Cardiol. 1982;50:1185.

    Article  CAS  PubMed  Google Scholar 

  • Steele RM, Schuna AA, Schreiber RT. Calcium antagonist-induced gingival hyperplasia. Ann Intern Med. 1994;120:663–4.

    Article  CAS  PubMed  Google Scholar 

  • Zalman F, Perloff TK, Durant NN, et al. Acute respiratory failure following intravenous verapamil in Duchenne’s muscular dystrophy. Am Heart J. 1983;105:510.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Ottawa The Ottawa Hospital, Ottawa, ON, Canada

    M. Gabriel Khan MD, FRCPC, FRCP (London), FACC

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  1. M. Gabriel Khan MD, FRCPC, FRCP (London), FACC
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© 2015 Springer Science+Business Media New York

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Khan, M.G. (2015). Calcium Antagonists (Calcium Channel Blockers). In: Cardiac Drug Therapy. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-962-4_5

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  • DOI: https://doi.org/10.1007/978-1-61779-962-4_5

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61779-961-7

  • Online ISBN: 978-1-61779-962-4

  • eBook Packages: MedicineMedicine (R0)

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