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Because of the negative inotropic effects, the nondihydropyridine calcium channel blockers should be avoided (or used with caution) in individuals with cardiomyopathy. [35] Unlike beta blockers, calcium channel blockers do not decrease the responsiveness of the heart to input from the sympathetic nervous system.
While negative inotropism may precipitate or exacerbate heart failure in the short term, certain beta blockers (e.g. carvedilol, bisoprolol and metoprolol) have been believed to reduce long-term morbidity and mortality in congestive heart failure. [13] Examples of negative inotropic agents include: Beta blockers [14]
Non-dihydropyridine calcium channel blockers such as verapamil block the slow inward calcium current in cardiac tissues, thereby having a negatively dromotropic, chronotropic and inotropic effect. [5] This (and other) pharmacological effect makes these drugs useful in the treatment of angina pectoris.
Molecules that act as channel blockers are important in the field of pharmacology, as a large portion of drug design is the use of ion channel antagonists in regulating physiological response. The specificity of channel block molecules on certain channels makes it a valuable tool in the treatment of numerous disorders.
Compared with certain other L-type calcium channel blockers (for example those of the phenylalkylamine class such as verapamil) that have significant action at the heart, the dihydropyridine calcium channel blockers lower blood pressure mainly by relaxing the smooth muscle of the blood vessel walls. [3]
Antihypertensive agents are classified according to their mechanism of actions. The most common classes prescribed are diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs) and beta-blockers. Antihyperlipidemic agents most often prescribed are statins, ezetimibe and ...
Itraconazole (Onmel/Sporanox) exhibits a negative inotropic effect on the heart and thus could spur an additive effect when used concomitantly with isradipine. Itraconazole also inhibits an important cytochrome liver enzyme (CYP 450 3A4) which is needed to metabolize isradipine and other calcium channel blockers.
Dihydropyridine calcium channel blockers can produce negative inotropic effects and exacerbate heart failure. Heart failure patients should be monitored carefully. Cleviprex gives no protection against the effects of abrupt beta-blocker withdrawal. Most common adverse reactions (>2%) are headache, nausea, and vomiting.