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Canadian Anaesthetists' Society Journal Jan 1985
Review
Topics: Animals; Benzazepines; Blood Vessels; Calcium; Coronary Circulation; Coronary Disease; Diltiazem; Drug Interactions; Halothane; Heart; Hemodynamics; Humans; Kinetics; Muscle, Smooth, Vascular; Muscles; Muscular Diseases; Myocardial Contraction
PubMed: 3882198
DOI: 10.1007/BF03008535 -
Drugs & Aging 1993Diltiazem is a benzothiazepine derivative calcium antagonist available in several formulations, some of which enable once daily administration. The drug as monotherapy... (Comparative Study)
Comparative Study Review
Diltiazem is a benzothiazepine derivative calcium antagonist available in several formulations, some of which enable once daily administration. The drug as monotherapy has demonstrated similar efficacy to diuretics in older patients with hypertension. Data comparing diltiazem with beta-blockers and angiotensin converting enzyme inhibitors are more limited, but available studies suggest at least comparable antihypertensive efficacy. Diltiazem as monotherapy or in combination with a beta-adrenoceptor-antagonist, isosorbide dinitrate, or another calcium antagonist, has demonstrated efficacy in patients with effort angina. The drug has also been used intravenously to terminate supraventricular tachycardias and to control the ventricular response to atrial fibrillation or flutter; it also appears to reduce the rate of early reinfarction in patients with non-Q-wave myocardial infarction. The most common adverse events during diltiazem therapy include headache, flushing, peripheral oedema and hypotension. Atrioventricular block although rare, is the most frequent serious adverse event related to diltiazem therapy and may be exacerbated by coadministration of beta-adrenoceptor antagonists, especially in the elderly. Thus, diltiazem appears to be an effective and well tolerated treatment for hypertension and angina in older patients and has shown promise as therapy for supraventricular tachycardias and as prophylaxis against early reinfarction in patients with non-Q-wave myocardial infarction.
Topics: Adult; Aged; Aged, 80 and over; Aging; Diltiazem; Humans; Middle Aged
PubMed: 8369596
DOI: 10.2165/00002512-199303040-00007 -
Drug Intelligence & Clinical Pharmacy May 1982
Review
Topics: Angina Pectoris; Animals; Benzazepines; Chemical Phenomena; Chemistry; Chemistry, Pharmaceutical; Diltiazem; Drug Interactions; Humans
PubMed: 7044735
DOI: No ID Found -
Drugs May 1985Diltiazem is an orally and intravenously active calcium channel blocking agent shown to be an effective and well-tolerated treatment for stable angina and angina due to... (Review)
Review
Diltiazem is an orally and intravenously active calcium channel blocking agent shown to be an effective and well-tolerated treatment for stable angina and angina due to coronary artery spasm. Its efficacy in these diseases has generally been similar to that of nifedipine or verapamil - alternative calcium channel blockers with which diltiazem has many electrophysiological, haemodynamic, and antiarrhythmic similarities. The antianginal mechanism of diltiazem cannot be precisely described; however, it appears to increase myocardial oxygen supply and decrease myocardial oxygen demand, mainly by coronary artery dilatation and/or via both direct and indirect haemodynamic alterations. Diltiazem has also shown substantial efficacy in the treatment of unstable angina, hypertension, and supraventricular tachyarrhythmias, but further study is necessary before its place in the treatment of these diseases may be clearly established. Although headache due to peripheral vasodilatation and depression of atrioventricular nodal conduction may be troublesome, side effects occur in only 2 to 10% of patients receiving diltiazem and are generally minor in nature. Thus, diltiazem offers a worthwhile alternative to other agents currently available for the treatment of angina pectoris. Although the infrequency of serious side effects may offer an advantage, its relative place in therapy compared with that of other calcium channel blockers remains to be clarified.
Topics: Angina Pectoris; Animals; Arrhythmias, Cardiac; Benzazepines; Coronary Disease; Digitalis Glycosides; Diltiazem; Drug Interactions; Electrophysiology; Heart; Hemodynamics; Humans; Hypertension; Kinetics; Muscle, Smooth; Muscle, Smooth, Vascular; Physical Exertion; Renal Circulation
PubMed: 3891302
DOI: 10.2165/00003495-198529050-00001 -
Journal of Clinical Pharmacology Mar 1995Diltiazem hydrochloride is a benzothiazepine derivative calcium-channel blocker with proven antianginal and antihypertensive capabilities. Its primary mechanism of... (Comparative Study)
Comparative Study Review
Diltiazem hydrochloride is a benzothiazepine derivative calcium-channel blocker with proven antianginal and antihypertensive capabilities. Its primary mechanism of action is vasodilatation, which results in diminished vascular resistance and improved perfusion to various vascular beds and target organs. The antihypertensive efficacy of diltiazem in various demographic groups has been studied and compared with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, and other calcium-channel blockers. These studies have shown that the antihypertensive effect of diltiazem is similar to that of the other therapies. Diltiazem does not adversely affect electrolytes or carbohydrate or lipid metabolism, and it may have beneficial effects on the heart and kidneys. Diltiazem reduces myocardial hypertrophy and exerts antianginal effects on the heart through coronary vasodilation and reduction in the blood pressure double product. Diltiazem improves renal perfusion and attenuates proteinuria. These effects may be helpful in limiting the progression of renal injury. Overall, the efficacy and tolerability of diltiazem, as well as its salutary effects on the heart and kidneys, make it an important therapeutic consideration for patients with hypertensive disease.
Topics: Antihypertensive Agents; Black People; Clinical Trials as Topic; Diltiazem; Female; Heart; Hemodynamics; Humans; Hypertension; Kidney; Male; Quality of Life; White People
PubMed: 7608309
DOI: 10.1002/j.1552-4604.1995.tb04051.x -
The Journal of Emergency Medicine 1991We present a case of diltiazem overdose in which the patient ingested 4.2 grams in an apparent suicide attempt. He arrived in the emergency department two hours... (Review)
Review
We present a case of diltiazem overdose in which the patient ingested 4.2 grams in an apparent suicide attempt. He arrived in the emergency department two hours postingestion with a blood pressure of 60/40 torr and a heart rate of 62 beats/min in a junctional rhythm. Intervention included activated charcoal, gastric lavage, intravenous fluids, calcium (both chloride and gluconate), dopamine, and atropine with improvement in vital signs. Diltiazem levels were obtained and half-life calculated. This ingestion is one of the largest reported in the literature and is remarkable in that the patient recovered without pacing or other extraordinary measures. All eight previously published cases of diltiazem overdose, including all unpublished reports to the manufacturer, are reviewed and their management strategies examined. Successful treatment in which recovery has occurred in less than 48 hours, includes pressors, calcium, glucagon, pacing, and charcoal hemoperfusion. A strategy for emergency physicians to use when approaching this problem is suggested from the review.
Topics: Adult; Combined Modality Therapy; Diltiazem; Half-Life; Humans; Male; Poisoning; Suicide, Attempted
PubMed: 1940240
DOI: 10.1016/0736-4679(91)90380-x -
Drugs May 1990Diltiazem is a calcium antagonist effective in the treatment of stable, variant and unstable angina pectoris and mild to moderate systemic hypertension, with a generally... (Review)
Review
Diltiazem is a calcium antagonist effective in the treatment of stable, variant and unstable angina pectoris and mild to moderate systemic hypertension, with a generally favourable adverse effect profile. It is also effective in terminating supraventricular tachycardia and in controlling the ventricular response to atrial fibrillation/flutter. Atrioventricular block, the risk of which may be exacerbated by concomitant beta-adrenoceptor antagonist therapy, occurs rarely as an adverse effect of diltiazem treatment. Diltiazem appears to exert complex cardioprotective effects which have been of benefit after intracoronary administration to patients undergoing coronary angiography and bypass procedures. In addition, long term diltiazem treatment has produced a significant reduction in subsequent cardiac events in patients with non-Q wave myocardial infarction. Thus, diltiazem is an effective and well-tolerated first-line or alternative treatment of patients with ischaemic heart disease, systemic hypertension, and supraventricular arrhythmias, with possible potential in limiting ischaemia-induced myocardial damage.
Topics: Arrhythmias, Cardiac; Coronary Disease; Diltiazem; Humans; Hypertension; Muscle, Smooth
PubMed: 2191851
DOI: 10.2165/00003495-199039050-00009 -
Yakugaku Zasshi : Journal of the... Aug 1988
Review
Topics: Animals; Antihypertensive Agents; Calcium Channel Blockers; Catalysis; Coronary Circulation; Diltiazem; Myocardium; Oxygen Consumption; Structure-Activity Relationship
PubMed: 3073210
DOI: 10.1248/yakushi1947.108.8_716 -
Drug Intelligence & Clinical Pharmacy May 1982
Review
Topics: Angina Pectoris; Animals; Benzazepines; Coronary Disease; Costs and Cost Analysis; Diltiazem; Humans; Kinetics
PubMed: 7044736
DOI: 10.1177/106002808201600503 -
Australian and New Zealand Journal of... Feb 1994
Topics: Aged; Diltiazem; Humans; Male; Myocardial Ischemia; Parkinson Disease, Secondary
PubMed: 8002867
DOI: 10.1111/j.1445-5994.1994.tb04434.x