ABSTRACT
The increase of multi-drug resistant Pseudomonas aeruginosa infections is a worldwide dilemma. At the heart of the problem is the inability to treat established P. aeruginosa biofilms with standard antibiotic therapy, including fluoroquinolones. We address a previously unstudied question as to the effect of a commonly prescribed calcium channel blocker [CCB] diltiazem on the biofilm growth. Real-time monitoring of the overall growth and killing of P. aeruginosa biofilm during fluoroquinolones therapy in the presence and absence of diltiazem was performed. In this study, we demonstrate that for P. aeruginosa biofilms, resistance to the first-line fluoroquinolones may be induced by the commonly prescribed calcium channel blocker diltiazem
Subject(s)
Drug Resistance, Bacterial , Fluoroquinolones , Diltiazem/adverse effects , Drug Interactions , Biofilms , Pseudomonas Infections/drug therapy , Drug Resistance, MultipleABSTRACT
To evaluate the effect of diltiazem on the adrenergic manifestations of hyperthyroidism and thyroid function tests. This prospective, interventional study included 19 newly diagnosed patients [16 females, 3 males with mean age of 35.31 + 10.36 years] of hyperthyroidism attending the out patient department of Institute of Radiotherapy and Nuclear Medicine, Peshawar. All patients took diltiazem 30 mg three times a day for 6 weeks. Clinical assessment was done before starting therapy and then serially after 1, 2, 4 and 6 weeks [+3 days] using standardized and modified hyperthyroid symptom score. Serum free T4 measurements were done before starting diltiazem and then serially after 2, 4 and 6 weeks [+3 days] of therapy. Following therapy with diltiazem the hyperthyroid system score decreased significantly at 1, 2, 4 and 6 weeks of therapy. With individual values dropping from 14.42 to 12.89 pmol/L after 1week [P < 0.05], to 11.21, 10.78 and 10.26 pmol/L after 2, 4 and 6 weeks, respectively [P < 0.001]. Serum free T4 decreased from 33.29 pmol/L to 32.77, 31.86 and 31.50 pmol/L after 2, 4 and 6 weeks [P > 0.05]. Diltiazem effectively controls the clinical manifestations of hyperthyroidism. It also causes some decline in free thyroxine levels
Subject(s)
Humans , Male , Female , Diltiazem , Diltiazem/adverse effects , Hyperthyroidism/drug therapy , Treatment Outcome , Thyroid Function Tests , Prospective Studies , Thyroxine , Receptors, Adrenergic, beta , CatecholaminesABSTRACT
A 65-year old man on treatment for ischaemic heart disease presented with a history of pain and weakness of all four limbs and dry mouth. He had clinical and neurophysiological features of Lambert-Eaton myasthenic syndrome. His symptoms improved after withdrawal of diltiazem, although neurophysiological changes remained even after 3 months.
Subject(s)
Aged , Diltiazem/adverse effects , Disease Progression , Electromyography , Follow-Up Studies , Humans , Lambert-Eaton Myasthenic Syndrome/complications , Male , Myocardial Ischemia/complications , Neurologic Examination , Risk Assessment , Severity of Illness Index , Sri LankaABSTRACT
Constituyen un grupo importante de medicamentos ampliamente utilzados en la práctica diaria, que farmacológicamente se caracterizan por bloquear los canales lentos del calcio.
Subject(s)
Calcium Channel Blockers/classification , Dihydropyridines , Dihydropyridines/adverse effects , Dihydropyridines , Dihydropyridines/pharmacology , Diltiazem , Diltiazem/adverse effects , Diltiazem , Diltiazem/pharmacology , Verapamil , Verapamil/adverse effects , Verapamil , Verapamil/pharmacologyABSTRACT
Objetivo - Avaliar o efeito, do dilitiazem versus placebo na angina estável (AE). Métodos - Oitenta e sete pacientes com AE, idade média de 57 ñ 9 anos, 82 brancos 79 do sexo masculino. Avaliaçäo duplo-cega, randomizada em 2 grupo de pacientes, diltiazem e placebo, 3 a 4 comprimidos ao dia (180 a 240 mg de diltiazem ao dia). Foram realizados avaliaçöes clínico-ergométrica, laboratorial e cinecoronariográfica (prévia). Resultados - As médias do número de crises de angina, do consumo de nitrato sublingual por semana, da freqüência cardíaca, da pressäo arterial siostólica e diastólica em repouso e no final do período diltiazem, foram significativamente menores (p < 0,05) do que os respectivos valores do período placebo. O percentual do infradesnivelamento do segmento ST foi significativamente (p < 0,05) menor no grupo diltiazem quando comparado com o grupo placebo e o percentual de pacientes que atingiram estágios mais elevados no teste ergométrico foi signficativamente maior no grupo diltiazem quando comparado com o grupo placebo. A freqüência cardíaca e as pressöes arteriais sistólica e diastólica no final do exercício do grupo diltiazem näo variaram significativametne quando comparadas com o grupo placebo. Conclusäo - O diltiazem demonstrou ser capaz de reduzir as manifestaçöes clínicas e eletrocardiográficas da isquemia miocárdica e de aumentar a tolerância ao esforço no teste ergomêtrico, em pacientes com angina estável
Purpose - To evaluate the efficacy of diltiazem versus placebo in patients with stable angina. Methods - Eight-seven angina pectoris patients,mean age of 57 + 9, 82 white and 79 male were evaluated in a randomized, double-blind trial of two groups of patients diltiazem and placebo, 3 to 4 tablets a day (diltiazem 180 to 240 mg daily). The patients were evaluated-after laboratory tests and clinical-ergometric examinations. A coronary arteriography was performed on study entry. Results - The average of anginal attacks, number of weekly sublingual nitrate, heart rate, systolic and diastolic pressure at rest and at the end of diltiazem period were significantly lower (p < 0,05) regarding same periods on placebo. The percentage of depression for ST-segment was lower for diltiazem when compared with placebo (p < 0,05) and the percentage of patients that reach higher stages in the ergometric test was significantly better for diltiazem. Heart rate and systolic plus diastolic pressures after exercise did not differ in both groups. Conclusion - Diltiazem reduced the clinical and electrocardiographical aspects and raises the effort tolerance during the ergometric test in patients with stable angina
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diltiazem/therapeutic use , Coronary Disease/drug therapy , Angina Pectoris/drug therapy , Diltiazem/administration & dosage , Diltiazem/adverse effects , Coronary Disease/complications , Angina Pectoris/complications , Randomized Controlled Trials as Topic , Heart Rate , Double-Blind Method , Arterial Pressure , Exercise TestABSTRACT
Por poseer acciones intermedias entre verapamilo y dihidropiridinas, el Diltiazem-90 (D) representa una alternativa como parte del enfoque terapéutico individualizado de pacientes hipertensos. Este estudio se orientó a conocer su eficacia, sus efectos secundarios y el comportamiento de algunos parámetros de laboratorio en hipertensos esenciales leves a moderados, mayores de 55 años, a través de un seguimiento de 12 semanas. Después de 4 semanas de medidas generales se indicó D, 90 mg c/12 hrs en 42 pacientes cuyas presiones diastólicas (PD) persistieron sobre 94 mm Hg, previéndose duplicar la dosis si la PD era mayor de 89 mm Hg al cabo de otras 4 semanas. Por último, se concibió la asociación de 25 mg de hidroclorotiazida (HCT) en caso de no alcanzar ese objetivo en igual período. Los promedios de PD y presión sistólica disminuyeron significativamente con D, tanto en posición sentado como de pie y no se presentó hipotensión ortostática. PD < 90 mm Hg se logró en 23 pacientes (55%) con 90 mg c/12 hrs, en 14 (33%) con 180 mg c/12 hrs y en 5 (12%) con la asociación de HCT. En 7 pacientes (16,8%) hubo efectos secundarios pasajeros y de escasa intensidad. Los exámenes de laboratorio realizados no experimentaron variaciones significativas, incluyeron: glicemia, creatininemia, uricemia, colesterolemia, HDL-colesterol, triglicéridos, orina y electrolitos plasmáticos. El presente estudio comprueba la utilidad clínica del Diltiazem de liberación sostenida en hipertensos leves y moderados mayores de 55 años