Diltiazem Health Dictionary

Calcium-channel blockers inhibit the inward ?ow of calcium through the specialised slow channels of cardiac and arterial smooth-muscle cells. By thus relaxing the smooth muscle, they have important applications in the treatment of HYPERTENSION and ANGINA PECTORIS. Various types of calcium-channel blockers are available in the United Kingdom; these di?er in their sites of action, leading to notable di?erences in their therapeutic effects. All the drugs are rapidly and completely absorbed, but extensive ?rst-pass metabolism in the liver reduces bioavailability to around one-?fth. Their hypotensive e?ect is additive with that of beta blockers (see BETA-ADRENOCEPTOR-BLOCKING DRUGS); the two should, therefore, be used together with great caution – if at all. Calcium-channel blockers are particularly useful when beta blockers are contraindicated, for example in asthmatics. However, they should be prescribed for hypertension only when THIAZIDES and beta blockers have failed, are contraindicated or not tolerated.

Verapamil, the longest-available, is used to treat angina and hypertension. It is the only calcium-channel blocker e?ective against cardiac ARRHYTHMIA and it is the drug of choice in terminating supraventricular tachycardia. It may precipitate heart failure, and cause HYPOTENSION at high doses. Nifedipine and diltiazem act more on the vessels and less on the myocardium than verapamil; they have no antiarrhythmic activity. They are used in the prophylaxis and treatment of angina, and in hypertension. Nicardipine and similar drugs act mainly on the vessels, but are valuable in the treatment of hypertension and angina. Important di?erences exist between di?erent calcium-channel blockers so their use must be carefully assessed. They should not be stopped suddenty, as this may precipitate angina. (See also HEART, DISEASES OF.)... calcium-channel blockers

a break or rent of the mucosa of the anal canal, which commonly presents with anal pain during and immediately following defecation and the passage of bright red blood in the stools. Anal fissures may occur secondary to constipation and having to forcefully strain during the process of defecation or as a consequence of prolonged episodes of diarrhoea. Over time an anal fissure may fail to heal, leading to the development of a chronic fissure that is prone to perianal infection. Medical treatment includes stool softeners and topical smooth muscle relaxants (such as 2% diltiazem cream). Surgery for anal fissures refractory to medical treatment includes lateral sphincterotomy (cutting the muscle of the anal sphincter).... anal fissure

(calcium antagonist) a drug that inhibits the influx of calcium ions into cardiac and smooth-muscle cells; it therefore reduces the strength of heart-muscle contraction, reduces conduction of impulses in the heart, and causes *vasodilatation. Calcium-channel blockers, which include *amlodipine, *diltiazem, *nicardipine, *nifedipine, and *verapamil, are used to treat angina and high blood pressure.... calcium-channel blocker