Cardiovascular system, clinical agents

The effects of the prototypical calcium channel blockers are seen most prominently in the cardiovascular system (Table 19.1), although calcium channels are widely distributed among excitable cells. The following calcium channel-blocking drugs are clinically the most widely used compounds in this very extensive class of pharmacological agents amlodipine, diltiazem, isradipine, nifedipine, nicardipine, nimodipine, and verapamil. 

When calcium channel blockers are used clinically it is assumed that the major effects are limited to the cardiovascular system, and indeed, few side effects have been reported for these agents. However, calcium channels in the cardiovascular system... 

Thus, the TOR pathway and sirolimus in particular has been shown to be a promising approach to the treatment of a variety of vascular disorders, both mechanistically at the preclinical level and verified in the clinic, Clearly, there are serious liabilities and toxicities with this approach if it were to be used in a chronic systemic fashion, Immune modulation with such a powerful agent would not be an acceptable approach for treatment of cardiovascular disease, However, results here do point to pathways for study and opens possible further understanding of the potential for intervention in this serious condition affecting millions of patients,... 

Systemic beta-blockers are used extensively far the treatment of hypertension and other cardiovascular disorders. Of the available oral beta-blockers, atenolol, metoprolol, nadolol, pindolol, propranolol, and timolol have been documented to produce a dose-dependent reduction in lOP. The ocular hypotensive effect associated with systemically administered beta-blockers can be compared with that achieved with topically applied beta-blockers such as timolol. Although specific studies have not been conducted with most of the remaining systemic beta-blockers, these agents might also be expected to reduce lOP at clinically useful doses. 

---