Calcium Antagonists: Pharmacologic Agents in Search of New Clinical Indications

Author:

Gasser Robert1

Affiliation:

1. Division of Cardiology, Department of Medicine, Karl Franzens University, Graz, Austria

Abstract

The broad availability of new pharmacologic agents is usually followed by both the search for similar compounds with more specific and refined actions and the expansion of clinical applicability for these agents. During the last twenty years extensive investigations have revealed that calcium (Ca) antagonists hold a multifaceted pharmacodynamic potential that includes not only the antiarrhythmic and antihypertensive effects of the drug but also the protection against excessive Ca entry into the cells of the cardiovascular system and subsequent cell damage. The physiologic age-dependent Ca accumulation in the arterial wall, which inevitably appears after the second decade, reaches maximal values in the age group of eighty-one to ninety years when the aortic wall exhibits a total Ca content that is 100 times higher than in arteries of infants. In animals we also find age-dependent accumulation of Ca in the arterial wall that is severely aggravated by uncontrolled diabetes or hypertension. Fleckenstein has shown that this arterial calcinosis can be prevented by chronic administration of Ca antagonists. Furthermore, Fleckenstein has demonstrated that excessive Ca overload of myocardial tissue constitutes a basic pathologic process in the development of cardiac necroses—brought about by extreme beta-adrenergic drive (overdoses of catecholamines), high doses of vitamin D3, dihydrotachysterol, alimentary factors such as K or Mg deficiency, or genetic defects (hereditary cardiomyopathy). Even cardiac hypertrophy, either idiopathic or as a consequence of hypertension, can be prevented by the action of Ca antagonists. In addition, the uncontrolled Ca entry into the cell constitutes an important etiologic factor in microstructural impairment of the myocytes due to ischemia—hence Ca antagonists are successfully used as cardio-protective agents in cardioplegic solutions. More recently the tissue-protection action of Ca antagonists has also been proven to be effective in renal transplantation and inhibition of toxic liver injury. It can be concluded that Ca antagonists have an antiatherosclerotic, anticalcinotic, and tissue-protective potential that opens a wide spectrum of applications both prophylactic and therapeutic, especially in the cardiovascular field.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

Reference57 articles.

1. Fleckenstein A.: Metabolic aspects of the excitation-contraction coupling. In: The Cellular Functions of Membrane Transport, ed. by Hoffmann JF. Englewood, NJ: Prentice Hall, Inc., 1963, pp 71-93.

Cited by 9 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Na+/Ca++ exchanger gene expression during experimental ischemia is differentially regulated by β-blockers;Trace Elements and Electrolytes;2018-01-01

2. Anti-inflammatory activity of calcium channel blocker lercanidipine hydrochloride;Journal of Pharmacology and Pharmacotherapeutics;2013

3. A Novel Method for Resolution of Amlodipine;Organic Process Research & Development;2010-05-21

4. Dihydropyridine zur Behandlung der arteriellen Hypertonie: Therapieoptionen zur Blutdrucksenkung;Pharmazie in unserer Zeit;2005-09

5. Whatʼs in the Literature?;Journal of Clinical Neuromuscular Disease;2001-06

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3