Clinical Observation of Amlodipine Besylate Combined with Lisinopril and Hydrochlorothiazide,Atorvas-tatin in the Treatment of Severe Primary Hypertension Complicating with Carotid Atherosclerosis / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of amlodipine besylate combined with lisinopril and hydro-chlorothiazide,atorvastatin in the treatment of severe primary hypertension complicating with carotid atherosclerosis. METHODS:90 patients with severe primary hypertension complicating with carotid atherosclerosis were divided into control group (45 cases) and observation group(45 cases)according to random lottery form. Both groups were given Atorvastatin calcium tablet 20 mg/time orally,qd;control group was additionally given Amlodipine besylate tablet 5 mg/time orally,qd;observation group was additional-ly given Lisinopril and hydrochlorothiazide tablet 10 mg/time orally,qd,on the basis of control group. Both groups were treated for 8 weeks. Clinical efficacies of 2 groups were compared as well as blood pressure level,IMT,PV of carotid atherosclerosis, hs-CRP,TNF-α before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was significantly higher than that of control group,with statistical significance (P0.05). After treatment,the levels of SBP,DBP, IMT,PV,hs-CRP and TNF-α level in 2 groups were significantly lower than before;the observation group was significantly lower than the control group,with statistical significance (P0.05). CONCLUSIONS:Amlodipine besylate combined with lisinopril and hydrochlorothiazide,atorvastatin in the treatment of primary hypertension complicating with carotid atherosclerosis can effectively control the blood pressure level, delay the progression process of carotid atherosclerosis,reduce the inflammatory reaction degree,but dose not increase the occur-rence of ADR with good safety.

Efficacy of Jianpilishifang combined with magnesium sulfate and calcium antagonists in gestational hypertension / 中国生化药物杂志

Objective To observe the clinical effect of Jianpilishifang combined with magnesium sulfate and calcium antagonists in the treatment of gestational hypertension.Methods 81 cases from January 2014 to June 2015 in gynaecology and obstetrics department of Shengzhou City People’s Hospital were selected and divided into 41 patients in observation group and 40 patients in control group according to a randomized and double-blind method.The control group were treated with magnesium sulfate and calcium antagonist treatment and observation group were treated with Jianpilishifang treatment on the basis of control group.The systolic blood pressure, diastolic blood pressure, 24 h urinary protein (24 hUTP), urinary transferrin ( TRF) , blood viscosity, erythrocyte aggregation index and comparative treatment efficacy were compared pre-and post-treatment.Results The systolic blood pressure and diastolic blood pressure in observation group post-treatment were (125.73 ±5.48, 80.06 ±3.34)mmHg, which were lower than (140.16 ±7.02, 86.79 ±5.21)mmHg in control group (P<0.05).The levels of 24 hUTP and TRF in observation group post-treatment were (1.75 ± 0.14)g/24 h, (1.41 ±0.28)mg/L, which were lower than (2.55 ±0.18)g/24 h, (2.23 ±0.37)mg/L in control group (P<0.05).The blood viscosity, erythrocyte aggregation index in observation group post-treatment were (2.00 ±0.23)mPa? s, (3.11 ±0.20), which were lower than (2.56 ± 0.47)mPa? s, (3.69 ±0.41)in control group (P<0.05).The total effective rate was 95.12% in observation group, which was significantly higher than 80.00% in control group ( P<0.05 ) .Conclusion Jianpilishifang combined with magnesium sulfate and calcium antagonists could effectively reduce blood pressure and improve blood viscosity in the treatment of gestational hypertension.The therapeutic effect of combination therapy is superior to monotherapy.

Intoxicación grave con verapamilo / Severe intoxication with verapamil

Los calcioantagonistas, cada vez más usados en cardiología, son causas infrecuentes de intoxicaciones secundarias a intentos de suicidio o por mal uso de los mismos. Informamos de un caso con las manifestaciones clínicas clásicas descritas en la literatura y realizamos una investigación del tratamiento actual de dicha intoxicación.

Calcium channel blockers are currently widely used to treat many cardiological alterations; however, overdose and poisoning have been associated with morbidity and mortality mainly in those patients with suicidal attempts. We report a case and review the pathophysiology of overdose, treatment, and prognosis.

Calcium/also a double-edged sword? / 中国药理学通报

Calcium supplement is needed for Chinese people.Calcium antagonists are also used in China.Authors suggest that calcium owns dual direction effects like a double-edged sword.Based on the knowledge of calcium metabolism,the adverse drugs reactions of excessive calcium supplement and the harmful effects of cellular calcium overload are introduced.Scientific and efficient application of calcium agents and calcium antagonists is expected.

Analysis of Calcium Antagonists Used in Some Hospitals of Guangdong Province from 2002 to 2004 / 中国药房

OBJECTIVE:To evaluate the status quo and the tendency of calcium antagonists used in Guangdong Province.METHODS:The consumption sum,DDDs and the average daily expenses of calcium antagonists in Guangdong Province from2002to2004were analyzed statistically.RESULTS:The consumption sum of calcium antagonists from2002to2004increased year by year,with amlodipine leading the list of consumption sum and nifedipine leading the list of DDDs.CONCLUSIONS:Dihydropyridine calcium antagonists dominate Guangdong market.

The Effects of Verapamil and Nifedipine on Isolated Human Uterine Arteries / 대한마취과학회지

Isometric tension was recorded in uterine arterial ring preparation contracted by potassium (60 mM) and norepinephrine(1.8 X 10(-7) M). With pretreatment of various concentrations of nifedipine(2.9 x 10(-9) ~2.9 X10(-7) M) and verapamil(2.2 X 10(-7) -2.2 X 10(-5) M), the relaxation was dose-dependent and inhibitory effects of both agents were more marked on the potassium than norepinephrine-evoked contraction. After immersion of the arterial preparation in calcium-free solution, the potassium-evoked contraction was decreased to 21+/-4.1%(mean+/-SEM) of the response in normal Krebs solution and norepinephrine-evoked contraction to 26+/-3.8%. The responses to both agents were completely restored when the calcium concentration was increased to 4.0 mM. Pretreated nifedipine(2.9 x 10(-7) M) in calcium-free solution depressed the potassium-evoked contraction to 7.3+/-1.6% and norepinephrine-evoked contraction to 12+/-3.7%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 30+/-4.6% and that by norepinephrine to 45+/-5.4%. Pretreated verapamil(2.2 X 10(-5) M) in calcium-free solution depressed the potassium-evoked contraction to 14+/-3.6% and norepinephrine-evoked contraction to 18+/-3.3%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 41+/-4.2% and that by norepinephrine to 57+/-4.7%. It was concluded that nifedipine and verapamil relaxed KC1 contracted ring in the presence of external calcium and relaxed norepinephrine contracted ring in both the presence and absence of external calcium. These findings suggest that calcium antagonists interfere with the release of calcium from intracellular sites as well as with the slow inward current of calcium.

Asma y nifedipina: estudio comparativo del efecto profilactico de la nifedipina frente al ketotifeno y placebo en asma alergica infantil / Asthma and nifedipine: comparative study of the profilactic effect of nifedipine against ketotifen and placebo in child's allergic asthma

Se presentan los resultados de un estudio doble ciego, al azar, que compara los efectos de la nifedipina, una dihidropiridina antagonista del calcio, de amplia utilizacion cardiovascular, con los del Ketotifeno y los de un placebo; cada uno de ellos fue administrado por via oral cada 12 horas, durante 4 meses, a un grupo de 20 ninos mayores de 5 anos con asma alergica de una evolucion minima de 2 anos; el estudio se llevo a cabo en el Servicio de Alergias del Hospital Universitario San Vicente de Paul, de Medellin, Colombia, entre Julio de 1984 y Diciembre de 1986. La nifedipina produjo disminucion de la frecuecnia de las crisis en 17 pacientes (85%) y de su intensidad y duracion en 16 (80%); en esta misma proporcion (80%) se disminuyo el consumo de broncodilatadores; 18 pacientes (90%) informaron efectos beneficos de la nifedipina y la mejoria, evaluada por el medico, se hallo en 14 (70%). No hubo con la nifedipina modificaciones del pulso ni de la presion arterial ni, tampoco de 14 pruebas de funcion pulmonar; los efectos secundarios fueron minimos y autolimitados. Los resultados obtenidos con la nifedipina fueron estadisticamente semejantes a los de ketotifeno y los de ambos significativamente superiores a los logrados con el placebo(p<0.05)En conclusion: la nifedipina podria ser una alternativa en le manejo del asma alergica infantil leve o moderada, dado su comportamiento similar al del ketotifeno que es de eficacia reconocida en este campo; en un futuro los antagonistas del calcio pueden llegar a ser el tratamiento de elección del paciente asmatico si..

Between July 1984 and December 1986 a double blind randomized study was conducted at the Allergy Clinic of the Hospital Universitario San Vicente de Paúl, Medellín, Colombia, in order to compare the effects of Nifedipine, Ketotifen and placebo on allergic asthma in children; each drug and the placebo were administered orally every 12 hours for a period of 4 months to a group of 20 children. The objective was to evaluate the usefulness of Nifedipine In the prophylactic management of allergic asthma in this population and to compare it with Ketotifen, a provenly efficacious drug, and placebo. AII patients were older than 5 years and had suffered the disease for more than 2 years. Nifedipine treated patients showed a reduction in the frequency of their asthmatic crisis (17 patients; 85%) and in their intensity and duration (16 patients; 80%); a similar reduction was observed In the need for bronchodilators; 18 patients (90%) reported beneficial effects with this drug and medical evaluation confirmed Improvement In 14 (70%). These results resembled those obtained with Ketotifen and both were statistically superior to placebo (p<0.05). Pulmonary function tests, pulse rate and blood pressure did not show any significant changes. Secondary effects were minimal and self-Limited. It is concluded that Nifedipine can be an alternative drug for the treatment of mild to moderate allergic asthma in children. If calcium antagonists with higher affinity for the respiratory tract and better blocking effects are synthesized they might become the elective therapeutic choice for these patients

EFFECT ON INTRACELLUIAR LIPID METABOLISM BY VERAPAMIL AND GLUCOSYLATED LDL / 中国药理学通报

This study was designed to investigate the effects of calcium antagonists and glucosylated LDL on intracellular lipid metabolism . The human serum LDL was isolated by density gradient ultracentri-fugation and glucosylated by incubation with glucose. The content of intracellular cholsterol was determined by enzymatic method which is simple, convenient and satisfactory. It was found that the contents of cholesterol in cultured human fibroblasts incubated with verapamil and(or)glucosylated LDL were higher than those incubat- ed with control LDL or without verapamil. The results suggested that calcium antagonists and glucosylation of LDL might affect in-tracellular lipid metabolism and play a role in atherosclerosis.

EFFECTS OF VERAPAMIL ON DNA, RNA AND PROTEIN SYNTHESIS OF HUMAN FIBROBLASTS / 中国药理学通报

In order to investigate the action of calcium antagonists on metabolism of intracellular macromolecules, The authors observed the effects of verapamil on the incor-poration of 〔 3H 〕 TdR, 〔 3H 〕 UR and 〔 3H 〕 Leu into human fibroblasts. The inhibitory effects on DNA and RNA synthesis were concentration dependent, ID50 was l2.3mg/L and 22mg/L, respectively. The inhibitory effect on the synthesis of protein was weak.