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PubMed2000

The effect of calcium channel blocker diltiazem on photoreceptor degeneration in the rhodopsin Pro213His rat.

PURPOSE: To determine whether the calcium channel blocker D-cis-diltiazem promotes photoreceptor survival in rats with the Pro23His rhodopsin mutation. METHODS: Heterozygous Pro23His rhodopsin line 1 rats (n = 11) were treated daily, according to a protocol applied successfully in rd mice, with D-cis-diltiazem hydrochloride increased incrementally from 21 to 54 mg/kg in a divided dose (8 AM and 8 PM) administered by intraperitoneal (i.p.) injection for 21 days, beginning on days of age 10 through 12. Saline-treated line 1 rats (n = 6) received i.p. injections of an equal volume of 0.9% saline. Analysis on day 35 of age included dark-adapted corneal electroretinogram (ERG) b- and a-waves recorded from threshold to 0.63 log candela-seconds [cd-s]/m2, saturated a-waves elicited with a 2.1 log cd-s/m2 flash, and morphometry of the outer nuclear layer (ONL) and rod outer segments (ROS). RESULTS: ONL width and cell counts of diltiazem-treated and saline-treated animals at 35 days were reduced to 64%-68% of 15-day-old untreated P23H line 1 retinas. No photoreceptor rescue was found by measuring ONL width (P = 0.84), cell count (P = 0.42), or ROS length (P = 0.85). Functional assays by ERG b-wave threshold (P = 0.57), b-wave maximum amplitude (P = 0.46), and saturated a-wave amplitude (P = 0.59) also showed no rescue. CONCLUSIONS: D-cis-Diltiazem did not rescue photoreceptors of Pro23His rhodopsin mutation line 1 rats treated according to the protocol used in rd mouse.

Animals↗
PubMed2005

Calcium channel blocker inhibits Western-type diet-evoked atherosclerosis development in ApoE-deficient mice.

Calcium channel blockers slow the progression of atherosclerosis. The purpose of the present experiments was to examine the action of lacidipine in a condition that accelerates the development of atherosclerosis in order to test the hypothesis that the protective action of lacidipine in atherosclerosis is unrelated to the reduction of blood pressure. Male ApoE-deficient mice (6 weeks old) were exposed either to normal chow (ND) or to a Western-type diet (WD, adjusted calorie diet containing 42% from fat) for 8 weeks. Western-type diet induced a reduction of nitric oxide (NO)-mediated endothelium-dependent relaxation to acetylcholine (Max relaxation % = 55.8 +/- 2 for ND and 46.6 +/- 2 for WD, n = 8, p < 0.05). Dose-relaxation curves to S-nitroso-N-acetylpenicillamine (SNAP) NO donor were also significantly rightward-shifted (n = 7, ANOVA, p < 0.01) in WD compared with ND arteries. Chronic treatment of WD mice with lacidipine (1 and 3 mg/kg/day) increased significantly the acetylcholine-evoked relaxation (to 76.6 +/- 3.5%, n = 6, ANOVA, p < 0.001) and prevented the loss of responsiveness to SNAP in mice exposed to WD. Plasma renin activity and endothelin-1 plasma levels as well as thiobarbituric acid-reactive substance levels in kidneys were significantly lower in WD mice treated with lacidipine than in untreated ones. In mice exposed to WD lacidipine reduced extension of atherosclerotic lesions, renal injury and increase in blood pressure. Experimental data indicate that inhibition of Western-type diet-evoked alterations is related to both antioxidant and vasoactive properties of lacidipine.

Acetylcholine↗
PubMed2001

Potentiation by nitric oxide synthase inhibitor and calcium channel blocker of aspartame-induced antinociception in the mouse formalin test.

By applying a 12 day regimen of the non-calorific sweetener, aspartame, in combination with representative compounds of the calcium channel blocker and nitric oxide synthase inhibitor, we tried to investigate using a formalin-test in mice the relative role of aspartame on pain and its mechanism of action. Verapamil (2, 3.5, 5, 7.5 mg/kg) induced significant (P < 0.01) antinociception in both phases of the formalin test. L-Nitro-arginine-methyl-ester (L-NAME) at the doses used, induced significant (P < 0.01) antinociception in early phase (1, 2, 5, 10 mg/kg) and late phase (5, 10 mg/kg). Twelve days of treatment in animals by aspartame (0.16% w/v) significantly induced antinociception in both phases of the formalin test. Both verapamil (5 mg/kg) and L-NAME (10 mg/kg) significantly (P < 0.01) potentiated aspartame-induced antinociception in both phases of formalin test. The present findings support the hypothesis that the activation of NMDA receptors by aspartame modulates pain-related behaviour via a nitric oxide/cGMP/glutamate release cascade. It is concluded that aspartame would be a good analgesic agent if it would be used in combination with a calcium channel blocker or NOS inhibitor.

Analgesics↗
PubMed1991

Effect of S-312, a new calcium channel blocker, on the 1,4-dihydropyridine binding sites in porcine basilar blood vessels and rat aortic smooth muscle cells.

We examined the interaction of two isomers of S-312, a new calcium channel blocker with a bicyclic dihydrothienopyridine structure, with 1,4-dihydropyridine binding sites. Specific bindings of [3H]nitrendipine and (+)-[3H] PN200-110 in membranes prepared from porcine basilar blood vessels were saturable, reversible, and stereoselective, and had high affinities. The binding properties were very similar to those in membranes from other tissues such as the aorta, myocardium, and cerebral cortex. 1,4-Dihydropyridine calcium channel blockers competed for each radioligand binding in the order of: nisoldipine = nicardipine = S-(+)-S-312 greater than nifedipine greater than R-(-)-S-312. S-(+)-S-312 caused a decrease in the Kd values for both radioligands without changing the maximal binding capacity. 1,4-Dihydropyridines inhibited the high K(+)-induced increase in cytosolic free Ca2+ concentration in rat aortic smooth muscle A7r5 cells. S-(+)-S-312 was 3.3-4.9 times more potent than nicardipine or nisoldipine in inhibiting the Ca2+ increase, although S-(+)-S-312 bound to A7r5 cells with almost the same affinity. These and earlier findings show that S-(+)-S-312 exerts effects more potent than expected from the affinity for [3H]nitrendipine or (+)-[3H]PN200-110 binding sites. This was the case with R-(-)-S-312. These dihydrothienopyridine derivatives appear to interact with the Ca2+ channel in a manner slightly different from the conventional 1,4-dihydropyridines.

Animals↗
PubMedDate not supplied

Assessing the treatment of congestive heart failure: inotropic agents and calcium channel blockers.

Despite recent evidence that angiotensin-converting enzyme (ACE) inhibitors reduce mortality in patients with congestive heart failure (CHF), it is important to note that roughly 40% of patients with New York Heart Association class I-III disease treated with these agents died during 4-year follow-up in the treatment arm of two large trials. Given this high mortality rate, there is an obvious need for therapy beyond digoxin, diuretics, and ACE inhibitors. Digoxin is associated with favorable effects on exercise capacity, ejection fraction, and clinical symptomatology in the majority of patients with CHF. Its effects on mortality are unknown, but are the subject of a continuing trial sponsored by the National Institutes of Health. The beta-agonists are also associated with hemodynamic and clinical improvements in patients with CHF, but probably increase the risk of mortality, especially when taken on a long-term basis. Therefore, their use should be limited to the short-term management of acute exacerbations of CHF. Phosphodiesterase inhibitors, particularly milrinone, are associated with increased mortality in patients with CHF, apparently related to their arrhythmogenic effect. Little evidence exists that calcium channel blockers exert beneficial effects in patients with CHF (unlike their role in hypertrophic cardiomyopathy); indeed, first-generation calcium channel blockers may be detrimental in patients with left ventricular dysfunction and they should generally be avoided in this setting. Treatment of ischemia in patients with CHF should be initiated with nitrates; low dosages of vasoselective dihydropyridine calcium channel blockers may be attempted if nitrates fail.

Adrenergic beta-Agonists↗
PubMed1988

Effects of calcium-channel blockers on picrotoxin-induced centrogenic arrhythmias in cats.

Intravenous picrotoxin injection has been established as a model of producing arrhythmias, mainly through enhanced central sympathetic outflow. The effects of calcium-channel blockers, and a beta-blocker on these arrhythmias were tested in chloralose-anesthetized cats. Picrotoxin (10 mg/kg, i.v.) produced mostly ventricular, sometimes supraventricular tachycardias and ectopic beats, as well as a marked elevation of arterial blood pressure. Nifedipine at the doses of 2 micrograms/kg (i.v. or i.c.) and 5 micrograms/kg (i.v.) transiently suppressed the arrhythmias in some of the cats tested. With the dose of 10 micrograms/kg (i.v.), it promptly and consistently abolished the arrhythmias without recurrence and significantly reduced the blood pressure (-62 +/- 8/-59 +/- 8 mmHg, delta systolic pressure/delta diastolic pressure, p less than 0.001, n = 9). A similar degree of blood pressure reduction (-69 +/- 8/-67 +/- 7 mmHg, n = 6) after sodium nitroprusside (4-5 mg/kg, i.v.) injection abolished the arrhythmias in 4 of 6 cats; however, there was marked ECG evidence of myocardial ischemia in 3 cats. Verapamil (50 micrograms/kg, i.v.) transiently abolished the arrhythmias and significantly decreased the blood pressure (7/7 cats), whereas a larger dose (150 micrograms/kg) had a persistent effect (2/4 cats). Propranolol at a dose of 240 micrograms/kg also consistently abolished the arrhythmias without recurrence in all 4 cats. We conclude that nifedipine, verapamil and propranolol are effective in the treatment of picrotoxin-induced arrhythmias. This result indicates that calcium-channel blockers or beta-blockers may be clinically effective in the treatment or prevention of arrhythmias caused by intracranial lesions with enhanced sympathetic outflow.

Animals↗
PubMed1995

L-type calcium channel blockers modulate the microvascular hyperpermeability induced by platelet-activating factor in vivo.

PURPOSE: Platelet-activating factor (PAF) is a potent phospholipid mediator of the microvascular dysfunction associated with ischemia-reperfusion injury. Because changes in cytosolic-free Ca2+ concentration are essential in PAF cellular signaling, we formulated the hypothesis that blockade of Ca2+ entry may inhibit the PAF-induced microvascular dysfunction. METHODS: To investigate this hypothesis two L-type calcium channel blockers, verapamil and nifedipine, were applied to the hamster cheek pouch before the topical PAF challenge was undertaken. Permeability was assessed by measurement of the plasma clearance of fluorescein isothiocyanate dextran, 150,000 mol wt. The arteriolar diameter was measured simultaneously to evaluate the effects of L-type calcium channel blockers on PAF-induced vasoconstriction. RESULTS: Baseline clearance was 498.7 +/- 225.0 nl/60 min/gm (mean +/- SE). PAF at 10(-8) mol/L (n = 5) increased clearance to 3753.8 +/- 572.8 nl/60 min/gm (p < 0.01). Pretreatment with verapamil (2 mg/kg; n = 5) significantly reduced the increase in permeability caused by 10(-8) mol/L PAF (1909.1 +/- 620.2 nl/60 min/gm; p < 0.05). Nifedipine (5-10(-6) mol/L; n = 5) also significantly attenuated the impact of 10(-8) mol/L PAF (2037.2 +/- 427.5 nl/60 min/gm; p < 0.05). Neither verapamil nor nifedipine affected PAF-induced vasoconstriction. CONCLUSION: The significant inhibition of the increase in permeability by the L-type calcium channel blockers suggests that these compounds may be useful in the management of PAF-induced hyperpermeability.

Animals↗
PubMed2000

Venodilatory effect of pranidipine, a calcium channel blocker, monitored with perfluorocarbon in vivo (19)F-NMR spectroscopy.

We previously reported that the (19)F-NMR signal intensity of perfluorocarbon was increased by a venodilator, nitroglycerine, and decreased by an arteriodilator, hydralazine. In the present study, we demonstrated that pranidipine, a calcium channel blocker, increased the intensity of the FC-43 signal, while nifedipine, a prototype of calcium channel blockers, did not. These results suggest that pranidipine dilates the venous system in contrast to nifedipine.

Animals↗
PubMed1997

Fixed low-dose combination of an angiotensin converting enzyme inhibitor and a calcium channel blocker drug in the treatment of essential hypertension.

AIM: To review the possibilities of combination treatment in hypertension with special emphasis on the combination of an angiotensin converting enzyme (ACE) inhibitor and a calcium channel blocker. RESULTS: An increasing number of combination of drugs has become available. Fixed combinations, often low-dose, have proved suitable for the treatment of hypertension, even as first-line therapy. CONCLUSION: A fixed combination of an ACE inhibitor and a calcium channel blocker, in particular the combination of trandolapril and verapamil, is a suitable alternative to existing treatment modalities.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2004

Calcium channel blocker azelnidipine enhances vascular protective effects of AT1 receptor blocker olmesartan.

The present studies were undertaken to investigate the potential effect of a calcium channel blocker (CCB) to enhance the inhibitory effect of an angiotensin (Ang) II type 1 (AT1) receptor blocker (ARB) on vascular injury and the cellular mechanism of the effect of CCB on vascular remodeling. In polyethylene cuff-induced vascular injury of the mouse femoral artery, proliferation of vascular smooth muscle cells (VSMCs) and neointimal formation associated with activation of extracellular signal-regulated kinase (ERK), and tyrosine-phosphorylation of signal transducer and activator of transcription (STAT)1 and STAT3, inflammatory response assessed by monocyte chemoattractant protein-1 and tumor necrosis factor-alpha expression, as well as oxidative stress such as expression of NADH/NADPH oxidase p22(phox) subunit and superoxide production, were less in AT1a receptor null mice. Administration of nonhypotensive doses of a CCB, azelnidipine (0.5 or 1 mg/kg per day) attenuated these parameters in wild-type and AT1a receptor null mice. Coadministration of lower doses of an ARB, olmesartan (0.5 mg/kg per day), and azelnidipine (0.1 mg/kg per day), which did not affect vascular remodeling, significantly inhibited these parameters in wild-type mice. Moreover, the effective dose of azelnidipine (1 mg/kg per day) exaggerated the inhibitory action of olmesartan at effective doses of 1 or 3 mg/kg per day on VSMC proliferation in the injured arteries. These results suggest that azelnidipine could inhibit vascular injury at least partly independent of the inhibition of AT1 receptor activation and that azelnidipine could exaggerate the vascular protective effects of olmesartan, suggesting clinical possibility that the combination of CCB and ARB could be more effective in the treatment of vascular diseases.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2005

Design, synthesis, and biological testing of thiosalicylamides as a novel class of calcium channel blockers.

The current research aimed to investigate the importance of the heterocyclic ring system in the structure of the cardiovascular drug diltiazem for its calcium channel blocking activity. The manuscript describes the design, synthesis, and biological testing of a total of 10 S-(p-methoxybenzyl), N-substituted thiosalicylamides as a series of non-cyclic compounds derived from diltiazem's structure. The new compounds maintained all diltiazem pharmacophores except the thiazepine ring system. In vitro evaluation of the new series for calcium channel blocking effects revealed moderate activities with IC50 values in the range of 4.8-56.0 microM. The data suggest that the ring system is not essential for activity; however, its absence leads to a considerable drop of activity relative to that of diltiazem (IC50=0.3 microM). Compounds of the current series showed optimum activity when the aliphatic alkyl chain on the salicylamide nitrogen is part of a piperidine or piperazine ring system substituted at the terminal nitrogen with a benzyl group.

Animals↗
PubMed1990

Drug interactions: the new phosphodiesterase inhibitor enoximone and the calcium channel blocker nifedipine in coronary surgery patients--influence on hemodynamics and plasma concentrations.

The calcium channel blocker nifedipine and the new phosphodiesterase (PDE) inhibitor enoximone are used in the treatment of cardiovascular diseases. Since both substances are acting on slow calcium channels and because systemic elimination of these two agents is dependent on oxidative drug metabolizing enzyme activity, this study was performed in order to investigate hemodynamic changes and effects on plasma levels when both substances are given simultaneously. Forty-five patients undergoing aortocoronary bypass grafting were randomly subdivided into three groups: (a) group (n = 15) received 0.3 micrograms/kg/min of nifedipine as an infusion (N patients); (b) group (n = 15) received 0.5 mg/kg of enoximone as a bolus (E patients); and (c) group (n = 15) received nifedipine and enoximone in the same dosages (E + N patients). In addition to various hemodynamic variables, plasma levels of nifedipine, enoximone, and enoximone sulfoxide were measured until the end of the operation. Injection of enoximone was followed by an increase in cardiac index and right ventricular ejection fraction, decrease in pulmonary artery pressure, pulmonary capillary pressure, and systemic vascular resistance, whereas heart rate and mean arterial pressure remained almost unchanged. These changes were comparable for E and E + N patients. Plasma concentrations of enoximone and enoximone sulfoxide were not affected by nifedipine infusion and showed a comparable course in E and E + N patients. Nifedipine plasma level dropped to values less than 15 ng/ml at the end of extracorporeal circulation in N and E + N patients. It can be concluded that enoximone improved hemodynamics even in patients pretreated with nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

Inhibition of the A-23187-stimulated leukotriene and prostaglandin biosynthesis of rat basophil leukemia (RBL-1) cells by nonsteroidal anti-inflammatory drugs, antioxidants, and calcium channel blockers.

Rat basophil leukemia cells (RBL-1), when grown in monolayer, synthesize from endogenous substrates the prostaglandins (PG) E2, F2 alpha, and I2 (measured as 6-keto-PGF1 alpha) and 6-sulfidopeptide-containing leukotrienes (SRS), as well as materials that react serologically with anti-12-hydroxyeicosatetraenoic acid (HETE). The non-steroidal anti-inflammatory drugs indomethacin and aspirin inhibited PGE2 synthesis by RBL-1 cells, which had been stimulated with the calcium ionophore A-23187, in a dose-dependent manner with an IC50 of 0.7 and 7.8 microM respectively. Indomethacin, when used at higher concentrations, also inhibited iSRS synthesis with an IC50 of 230 microM. Benoxaprofen, also a non-steroidal anti-inflammatory drug, inhibited both PGE2 and iSRS production in a dose-dependent manner, but inhibition of the iSRS biosynthesis was three times more effective than inhibition of PGE2 production. The anti-oxidants gossypol, butylated hydroxyanisole (BHA), nordihydroguariatic acid (NDGA), and 3-amino-1-[m-(trifluoromethyl)phenyl]-2-pyrazoline (BW755c) also inhibited iSRS synthesis more effectively than PGE2 biosynthesis. The IC50 values for inhibition of iSRS production were 0.2 microM (gossypol), 0.5 microM (BW755c), 0.6 microM (BHA), and 0.6 microM (NDGA) compared to 2.8 microM (gossypol), 2.0 microM (BW755c), 4.8 microM (BHA) and 2.6 microM (NDGA) for inhibition of PGE2 synthesis. Gossypol, BW755C, BHA, and NDGA, as well as benoxaprofen, inhibited i12-HETE-biosynthesis (IC50 for gossypol, 0.32 microM; and for benoxaprofen, 0.5 microM). Two calcium channel blockers, verapamil and nifedipine, inhibited PGE2, iSRS and i12-HETE synthesis in a dose-dependent manner. The calcium channel blockers inhibited iSRS synthesis ten times more effectively than PGE2 production.

6-Ketoprostaglandin F1 alpha↗
PubMed1998

Calcium channel blockers in heart failure.

A considerable effort has been made in the last 15 years to evaluate the safety and efficacy of calcium channel blockers (CCBs) in the treatment of patients with chronic congestive heart failure (CHF). Available studies have provided strong evidence for a potential detrimental effect of the first-generation calcium antagonists in patients with CHF, indicating the need for great caution when these drugs are used in patients with significant depression of left ventricular systolic function. A number of second-generation CCB have demonstrated a strong vasodilatory effect and favorable hemodynamic action but failed to show a similar improvement in exercise capacity, morbidity and mortality. Moreover, drugs such as nicardipine and nisoldipine have resulted in a detrimental effect in some patients and, therefore, cannot be considered safe when used in patients with moderate-to-severe heart failure. Available information from the V-HeFT III study demonstrate a lack of an unfavorable effect of felodipine on exercise tolerance in patients with chronic heart failure. Although mortality rate was similar in both the felodipine and the placebo group, because of the relatively small number of patients in this study, no clear conclusion can be drawn regarding the effect of felodipine on mortality in patients with CHF. An encouraging signal regarding a potential role of CCB in the treatment of chronic heart failure has been provided by the recently completed PRAISE study. This prospective large-scale study demonstrated the safety of amlodipine, a long-acting dihydropyridine derivative, when used in patients with heart failure due to coronary artery disease. Furthermore, this study demonstrated a substantial reduction in mortality in patients with CHF due to nonischemic cardiomyopathy and provided a strong indication for a potential therapeutic benefit of amlodipine when added to standard CHF therapy in this patient population. No clear explanation is available at the present time regarding the reason for the deleterious effect demonstrated with some of the dihydropyridines and the contrasting benefit seen with amlodipine. Finally, more information regarding the safety and efficacy of dihydropyridines should become available in the next year. The PRAISE II study is ongoing and will provide further information regarding the therapeutic role of amlodipine in patients with nonischemic dilated cardiomyopathy. The MACH-1 study is evaluating the effect of mibefradil, a predominant T-type channel blocker with an ideal activity profile, on morbidity and mortality in patients with chronic CHF.

Calcium Channel Blockers↗
PubMed1997

A computerized intervention to decrease the use of calcium channel blockers in hypertension.

OBJECTIVE: To determine whether a computer-assisted reminder would alter prescribing habits for the treatment of hypertension in accordance with current clinical guidelines in a general internal medicine clinic. DESIGN: A randomized trial. SETTING: The General Internal Medicine Clinic of the Veterans Affairs Puget Sound Health Care System, Seattle Division. PATIENTS/PARTICIPANTS: Clinic providers were randomized to a control group (n = 35) or intervention group (n = 36). We targeted the providers of patients being treated for hypertension with calcium channel blockers, a class of drug not recommended for initial therapy. INTERVENTION: An automated computer query identified eligible patients and their providers. A guideline reminder was placed in the charts of patients of intervention providers; the charts of patients of control providers received no reminder. MEASUREMENTS AND MAIN RESULTS: During the 5-month study period, 346 patients were seen by the 36 primary care providers (staff physicians, nurse practitioners, residents, and fellows) in the intervention group, and 373 patients were seen by the 35 providers in the control group. Intervention providers changed 39 patients (11.3%) to other medications during the study period, compared with 1 patient (<1.0%) of control providers (p < .0001). For patients whose therapy was unchanged, providers noted angina in 23.1%, indications other than those for hypertension in 9.5%, intolerable adverse effects with first-line therapy in 13.9%, and inadequate control with first-line therapy in 13.9%. Of those patients without provider-indicated contraindications, 23.6% were switched from calcium channel blockers to first-line agents during the intervention period. CONCLUSIONS: The use of a computerized, clinic-based intervention increased compliance with guidelines in the treatment of primary hypertension in general, and decreased the use of calcium channel blockers for the treatment of hypertension in particular.

Aged↗
PubMedDate not supplied

Calcium channel blockers verapamil and nimodipine inhibit kindling in adult and immature rats.

The calcium channel blockers verapamil (VPM) and nimodipine (NMD) were administered to adult or immature (16-day-old) rats to determine their effects on amygdala-kindled seizures. The afterdischarge threshold (ADT) kindling rate and degree of postictal refractoriness were determined for two doses of VPM (0.5 and 5.0 mg/kg in rat pups and 2 and 10 mg/kg in adult rats) or 30 mg/kg nimodipine (NMD). Neither VPM nor NMD affected the ADT of the amygdala in adult or immature rats. VPM retarded the rate of kindling in both adult and immature rats in a dose-dependent manner; the number of stimulations required to progress through seizure stages were increased. NMD 30 mg/kg reduced the kindling rate and AD duration in both adult and immature rats. Neither drug was able to suppress recurrent seizures elicited by repetitive stimulation. These results suggest that verapamil, and possibly NMD may be of clinical utility in treatment of epilepsy, especially complex partial seizures.

Amygdala↗