ABSTRACT
Background: Calcium channel blockers (CCBs) are popular medicines used to treat hypertension, tachyarrhythmias or angina during pregnancy. Lack of adequate safety data has however created an uncertainty in the use of CCBs in pregnancy. Nifedipine has been reportedly associated with a variety of embryotoxic and fetotoxic effects in animals. Therefore, this study was undertaken to establish whether or not the commonly used CCBs (nifedipine and amlodipine) would produce teratogenic effects in rats.Methods: Twenty pregnant rats were randomly assigned to each of the treatment and control groups. Nifedipine and amlodipine were used in three dose levels of 5, 10, 20 mg/kg and 0.5, 1, 2 mg/kg body weight respectively to test its teratogenic effects. The maximum dose of the test drugs used in our study was ten times the maximum recommended human dose. The drugs were administered to the pregnant rats using nasogastric tubes from day 6 through day 15 of pregnancy. The number of live births, stillbirths, litter sizes, crown-rump lengths, birth weights and gross abnormalities of the pups delivered were observed and recorded. Skeletal changes and soft tissue changes were also observed in the pups delivered to treated pregnant rats.Results: It was found that nifedipine and amlodipine did not produce any teratogenic effects in rats at doses 2.5 to 10 times the recommended human dose. None of the pups showed any gross morphological, skeletal or visceral defects.Conclusions: Nifedipine and amlodipine appear to be safe during pregnancy in therapeutic doses.
ABSTRACT
Pulmonary hypertension(PH)has been defined as mean pulmonary arterial pressure(mPAP）≥25 mmHg at rest,measured by right heart catheterisation. The 6 th WSPH suggested a new pressure level to define an abnormal elevation as the mPAP>20 mmHg and the need for PVR≥3 WU to define the presence of pre-capillary PH. Regarding clinical classification,the main changes were the inclusion in group 1 of a subgroup“pulmonary arterial hypertension(PAH)long-term responders to calcium channel blockers”and a subgroup“PAH with overt features of venous/capillaries involvement“.
ABSTRACT
Background: Anal fissure is condition in which there are cut or tear in the distal anal cavity that associated with the spasm of the muscle of the internal anal sphincter. Simply anal fissure can be treated with simple measures through increase fibers intakes, laxatives, in addition to having a lots of drinks and in cases that not respond to these measures we use some topical preparations include CCBs, steroids, anesthetics. Aim: Topical CCBs mostly given for treatment of chronic anal fissures as it consider effective nonsurgical treatment for anal fissure and there are more than one CCBs including diltiazem and nifedipine to be used in treatment of anal fissure therefore this study was done in order to compare between these two drugs in term of their efficacy and tolerability. Method: In this study there are 65 patients was selected and interviewed during their visits to consultation clinics in Thi-Qar and distributed randomly between the two groups (Diltiazem group) and (Nifedipine group) as they use the drugs for 2 months topically for the perianal region the end point of this study was the healing within the predetermined period (3 months) and also made comparison for the tolerability between the 2 groups. Results: The healing rate with Nifedipine topical was higher significantly when compared with Diltiazem topical while in term of tolerability was there are no significant differences between the two groups the most common adverse effects that founded in the two group was perianal itching and burning sensation in the anal area. Conclusion: Availability of more than one topical from of CCBs for treatment of anal fissure needed to be investigated and according to the above results show that superiority for the topical nifedipine over diltiazem in treatment of anal fissure due to the higher rate of healing while in term of tolerability was no significant differences between them.