Nifedipine disease

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

Of all N Rs involved in xenobiotics metabolism induction, PX R is the most prominent one. PXR functions as a xenobiotic sensor and is activated by a large variety of chemically diverse compounds, for example lovastatin, nifedipine, rifampicin, SR12813, troglitazone or hyperforin (Chart 14.3), many of them standard therapeutic agents for common diseases [20-25]. 

Data on the effect of calcium antagonists on cardiovascular disease risks in patients with hypertension are available from one moderate-to-large scale randomized, placebo-controlled trial. In the Systolic Hypertension in Europe (Syst-Eur) trial, nitrendipine-based therapy produced an approximate 10/5 mmHg reduction in SBP-DBP in patients with systolic hypertension and a 42% reduction in the risk of stroke. Similar results were observed in two large, nonrandomized, placebo-controlled trials (with alternate treatment assignment), i.e. the Shanghai Trial of Nifedipine in the Elderly and the Systolic Hypertension in China (Syst-China) trial. 

Nifedipine may precipitate CHFand MI in patients with cardiac disease and peripheral ischemia,... 

Cummings JL, Miller B, Hill MA, et al Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol 44 389-393, 1987 Cundall RL, Brooks PW, Murray LG A controlled evaluation of lithium prophylaxis in affective disorders. Psychol Med 2 308-311, 1972 Cutler NR, Haxy J, Kay AD, et al Evaluation of zimeldine in Alzheimer s disease cognitive and biochemical measures. Arch Neurol 42 744-748, 1985 Czyrak A The effect of chronic nifedipine and ECS in the forced swimming test in rats. PolJ Pharmacol 45 191-195, 1993... 

Serious side effects are rare and result from improper use of these agents, as when intravenous verapamil (or diltiazem) is given to patients with sinus or atrioventricular nodal depression from drugs or disease, or nifedipine to patients with aortic stenosis. 

Dihydropyridines continue to be widely studied and clinically used as calcium channel antagonists. Compounds such as nifedipine 285, felodipine 286, and nicardipine 287 are standard clinically used medicines for the treatment of cardiovascular diseases such as hypertension. 1,4-Dihydropyridines have been discovered to have numerous other biological activities and a review of their diverse use as medicinal compounds was published in 2003 <2003MI2>. 

In conclusion, all dihydropyridines show a potent calcium channel antagonist activity, which is in turn translated into direct arteriolar spasmolytic effect that results in a beneficial vasodilatory activity. This is useful in some cardiovascular diseases, such as hypertension and angina, in which the peripheral resistances are raised due to increased calcium entry into the cells. Many analogues of nifedipine have been synthesized and introduced into the market, and each of these presents some common features and some peculiar differences. In particular ... 

A 64-year-old man with a history of ischemic heart disease underwent coronary angiography with 150 ml of iopromide (iodine 370 mg/ml). One hour later he had visual hallucinations (moving objects, pictures of familiar persons), which resolved about 40 hours later without any treatment. He had taken the following drugs for a year nifedipine 10 mg tds, metoprolol 50 mg bd, and aspirin 325 mg/day. His serum creatinine concentration was in the reference range and there was no history of allergies or previous exposure to contrast media. 

Ene MD, Roberts CJ (1987) Pharmacokinetics of nifedipine after oral administration in chronic liver disease. / Clin Pharmacol TJ-. 1001-1004. 

CALCIUM CHANNEL BLOCKERS BUSULFAN t plasma concentrations of busulfan and t risk of toxicity of busulfan such as veno-ocdusive disease and pulmonary fibrosis, when co-administered with diltiazem, nifedipine or verapamil Due to inhibition of CYP3A4-mediated metabolism of busulfan by these calcium channel blockers. Busulfan clearance may be l by 25%, and the AUC of busulfan may t by 1500 p,mol/L Monitor clinically for veno-ocdusive disease and pulmonary toxicity in transplant patients. Monitor busulfan blood levels as AUC of below 1500 p,mol/L per minute tends to prevent toxicity... 

Paraesthesiae in hands or feet give warning of peripheral ischaemia. Overdose can cause peripheral gangrene. Due to its complex actions on receptors, vasoconstriction is best antagonised by a nonselective vasodilator such as glyceryl trinitrate, nifedipine or sodium nitroprusside (rather than by an a-adreno-ceptor blocker). Patients with vascular disease, coronary and peripheral, are particularly at risk. 

A calcium-channel blocking drug, e.g. nifedipine or diltiazem, is an alternative to a p-adrenoceptor blocker use especially if coronary spasm is suspected or if the patient has myocardial insufficiency or any bronchospastic disease. It can also be used with a p-blocker, or... 

Xu JY, Li BX, Cheng SY. [Short-term effects of Angelica sinensis and nifedipine on chronic obstructive pulmonary disease in patients with pulmonary hypertension.] Zhongguo Zhong Xi Yi lie He Za Zhi 1992 12(12) 716-18,707. 

Nifedipine has been reported to cause agranulocytosis (85) and leukopenia was attributed to diltiazem the latter patient had scleroderma, active rheumatoid disease, and pulmonary fibrosis, but the white cell count fell after 3 weeks of diltiazem, recovered on withdrawal, and fell on rechallenge (86). Diltiazem has also been reported to cause immune thrombocytopenia in a 68-year-old man with angina (87). 

Furberg CD, Psaty BM, Meyer JV. Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation 1995 92(5) 1326-31. 

Sorkin EM, Clissold SP, Brogden RN. Nifedipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy, in ischaemic heart disease, hypertension and related cardiovascular disorders. Drugs 1985 30(3) 182-274. 

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