Calcium channel blockers CCBs

Figure 11.1. Structures of dihydropyridine calcium channel blockers (CCBs) (7-19).

The six main drug classes used, worldwide, for blood pressure lowering treatment are diuretics, jS-blockers, calcium channel blockers (CCB), ACE inhibitors, angiotensin II (All) receptor blockers and a-adrenergic blockers. In some parts of the world, reserpine and methyldopa are also frequently used. 

Oarbamazepine is increasingly recognized as an effective treatment for bipolar affective illness, whereas the data on nimodipine and related calcium channel blockers [CCBs] are much more preliminary. In this chapter, we review data on the efficacy and putative mechanisms of action of carbamazepine and nimodipine in the recurrent affective disorders. 

Calcium channel blockers (CCBs) prevent the flow of calcium ions through channels in heart tissue. Inhibiting calcium flow decreases the strength of contraction of the heart and decreases blood pressure. Most CCBs fall into the dihydropyridine structural class, with nifedipine (Adalat, A.132) being the prototypical example (Figure A.38). Nondihydropyridine CCBs include diltiazem (Cardizem, A.135) and verapamil (Calan, A.136). 

Renin-angiotensin-aldosterone system (RAAS), calcium channel blocker (CCB), and BB The combination of the drug Lotrel contains ACE and CCB, and the other combination is BIS and HCTZ. 

Mibefradil (Posicor ) was launched in the United States in June 1997 by Roche, Switzerland. It was promoted as a unique calcium channel blocker (CCB) that affected both transient (T) and long (L) calcium channels. At the time of launch, it was projected to eventually provide 1-3% of Roche s sales. It was withdrawn from the market in June 1998. 

Dihydropyridine calcium channel blockers (CCBs) have been used for many years in the treatment of angina pectoris and hypertension (81). Their mechanism of action is based on inhibition of the smooth muscle L-type calcium current, thereby... 

The use of diuretics, angiotensin-1 receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACE-I), calcium channel blockers (CCB), or p-blockers (BB) was associated with a reduced risk of AD in participants with normal cognition or MCI. Diuretic use was reported by 15.6 %, ARB 6.1 %, ACE-I 15.1 %, CCB 14.8 %, and BB 20.5 %. In cases with MCI, only diuretic use was associated with decreased risk [523]. Angiotensin-converting enzyme inhibitors (ACE-I) have beneficial effects on endothelial... 

Pfizer s Procardia XL is a once daily calcium channel blocker (CCB) for hypertension and angina. It delivers nifedipine via Alza s osmotic pump, a patented high-tech sustained-release (SR) formulation. Several generic companies are currently seeking FDA approval for an A/B substitute using low-tech SR formulations. The generic companies claim that they are not infringing Pfizer s patent estate, which includes ... 

Three landmark placebo-controlled clinical trials have established the benefits of both hypertension treatment and diuretic therapy. The Systolic Hypertension in the Elderly Program (SHEP), the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension), and the Medical Research Council (MRC) trial " showed significant reductions in stroke, myocardial infarction, and aU-cause cardiovascular disease and mortality with thiazide diuretic-based therapy versus placebo. These trials allowed for /3-blockers as add-on therapy for BP control. Newer agents (i.e., ACE inhibitors, angiotensin II receptor blockers [ARBs], and calcium channel blockers [CCBs]) were not available at the time of these studies. However, subsequent clinical trials have compared these newer antihypertensive agents (ACE inhibitors, ARBs, and CCBs) to diuretics." These data show similar effects, but most trials used a prospective, open-label, blinded end point (PROBE) study methodology that is... 

Calcium channel blockers (CCBs) enhance vasodilation by blocking L-type Ca " channels in cardiac and vascular tissues. Drugs considered are verapamil, diltiazem, and dihydropyriodines. 

Calcium channel blockers (CCBs) are the most widely used pharmacologic agents for the treatment of peripheral vasospasm (110-112). Sympatholytic agents have also been used in the treatment of Raynaud s phenomenon. Topical nitroglycerin ointment can be applied with a nocturnal nitrate-free interval to avoid nitrate tolerance. 

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