Haemodynamics and tissue specificity with isradipine

Abstract

The significant effects of isradipine in producing arterial vasodilatation and mild negative chronotropic effects without significant negative inotropic effects suggests that this agent should provide excellent antihypertensive efficacy in the treatment of perioperative hypertension. Isradipine may prove to be a safe antihypertensive treatment in patients with impaired ventricular function (cardiac failure), impaired myocardial perfusion (ischaemia), and in cases of selected conduction abnormalities or arrhythmias. The demonstration that its effects are limited to vascular resistance rather than vascular capacitance is an important distinguishing feature of isradipine compared with other antihypertensive agents. Finally, the potential application of this dihydropyridine calcium antagonist for cytoprotection and its effects on atherosclerosis remain exciting therapeutic prospects. K y words: Antihypertensive treatment; calcium antagonists; cardiovascular effects; isradipine; tissue-specific effects. 3 Curdiovasc Pharmacol 1991: 18 (suppl 3): S37-S40. 47. Rosenquist U, Ohman K P, Schenck H, et al. Antihypertensive and metabolic effect of isradipine in patients with hypertension and stable NIDDM. 3 Cardiovuc Pharmacol 1988: 12 (suppl 6): S 184. 48. Klauser R, Speiser P, Gisinger C, et al. Platelet aggregation and metabolic control are not affected by calcium antagonist treatment in type I1 diabetes mellitus. J Cardiovasc Pharmacol 1990: 15 (suppl 1): S93-S96.

Effects of isradipine on intravenous cocaine-induced cardiovascular response: a pilot study

“…Isradipine reduces calcium in¯ux into both the smooth muscle of arterioles and the myocardium (Apostolakos and Varon, 1996). Thus, dihydropyridine-class calcium channel antagonists have anti-hypertensive eects (Brogden and Sorkin, 1995), and impart a negative inotropic eect on the myocardium (Leslie, 1993). Isradipine is clinically approved for the treatment of hypertension (Mosby, 1997), and like other dihydropyridineclass calcium channel antagonists, has the potential to reduce cocaine's arryhythmogenic potential (Nahas et al, 1985;Trouve and Nahas, 1986).…”

Effects of Isradipine, a Dihydropyridine-Class Calcium Channel Antagonist, on D-Methamphetamine-Induced Cognitive and Physiological Changes in Humans

“…Isradipine's anti-hypertensive (Brogden and Sorkin 1995) and negative inotropic (Leslie 1993) effects are due to a combination of calcium influx inhibition into arteriolar and myocardial smooth muscle (Apostolakos and Varon 1996) and a reduction of DA release. Indeed, DA infusions have been used successfully to treat the peripheral vasodilatation and hypotension associated with overdose or toxicity to calcium channel antagonists (Pearigen and Benowitz 1991;Ramoska et al 1993).…”

Life‐Threatening Isradipine Poisoning in a Child

“…Isradipine has a greater selectivity for vascular smooth muscle than for myocardium or specialized conduction tissue. 10 Sinoatrial and atrioventricular nodes are dependent on calcium movement through the slow channels; thus, calcium channel blockers can produce a negative inotropic effect. 11 The greater degree of selectivity for peripheral vasodilatation seen with isradipine and other dihydropyridine derivatives is accompanied by the baroreflex-mediated increase in sympathetic tone such that the negative inotropic effect is not seen.…”