Calcium Entry or Calcium Channel Blockers

The calcium entry blockers or calcium channel blockers are a group of orally active drugs that have been approved for use in the treatment of vasospastic and ef fort-induced angina. These compounds block L-type voltage-dependent calcium channels in vascular smooth muscle and the heart, block platelet aggregation, and are particularly effective in the prophylaxis of coronary vasospasm or variant angina. In addition, these compounds are used in the chronic treatment of secondary angina. Two members of this group, vera-pamil (Calan) and diltiazem (Cardiazem), also have been approved for use in the therapy of certain supraventricular tachyarrhythmias (see Chapter 16). Other potential clinical uses of these compounds include systemic and pulmonary hypertension and Raynaud's syndrome

A detailed discussion of the pharmacology of this important class of drugs can be found in Chapter 19. Their major hemodynamic effects on the primary determinants of myocardial oxygen supply and demand are summarized in Figure 17.4. A comparison of the effects of all three classes of antianginal drugs on these important parameters is summarized in Table 17.4.

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