Introduction Atrial fibrillation (AF) is a common diagnosis of patients presenting to the emergency department (ED). Intravenous (IV) diltiazem bolus is often the initial drug of choice for acute management of AF with rapid ventricular response (RVR). The route of diltiazem after the initial IV loading dose may influence the disposition of the patient from the ED. However, no studies exist comp...

PURPOSE Because of a previous report suggesting that D-cis-diltiazem slows retinal degeneration in rd mice, this study was undertaken to examine the effect of D-cis-diltiazem on photoreceptor structure and function in this line of mice. METHODS Mice were randomly assigned to daily intraperitoneal injections of D-cis-diltiazem or saline between postnatal days 9 and 24. On postnatal day 26 or 2...

The tendency of oral diltiazem (a calcium entry blocking agent and a negative inotrope) to induce or exacerbate congestive heart failure when used for the long term management of myocardial ischaemia in patients with poor left ventricular function has not been investigated before. Twenty two patients (aged 42-73 years) with pretreatment left ventricular ejection fraction ranging from 0.11 to 0....

Diazepam is metabolized by CYP2C19 and CYP3A4 in the liver. CYP2C19 shows genetic polymorphism associated with the poor metabolizer (PM) and extensive metabolizer (EM) phenotypes. The aim of this study was to assess the effect of diltiazem, a CYP3A4 inhibitor, on pharmacokinetics and dynamics of diazepam in relation to CYP2C19 genotype status. Thirteen healthy volunteers (eight EMs and five PMs...

The contributions of amiloride-sensitive and -insensitive fractions of alveolar fluid clearance in adult ventilated rats were studied under control conditions and after beta-adrenergic stimulation. Rats were instilled with a 5% albumin solution containing terbutaline (10(-4) M) or dibutyryl-cGMP (DBcGMP; 10(-4) M) with or without the cyclic nucleotide-gated cation channel inhibitor l-cis-diltia...

PURPOSE Topical glyceryl trinitrate heals anal fissures, but a majority of patients experience headache. Topical gels of the calcium channel blocker diltiazem and the cholinomimetic bethanechol significantly lower anal sphincter pressure in volunteers. This study investigated the use of these two new pharmacologic agents in the treatment of patients with chronic anal fissure. METHODS Two stud...

CT is important for detecting subarachnoid clots and intracerebral or intraventricular hemorrhage. The presence of subarachnoid clots surrounding the cerebral arteries may be one of the causes of cerebral vasospasm. It is agreed that there is a correspondence between the site of subarachnoid clots and the location of cerebral vasospasm. The authors have already reported that the appearance and ...

Because an inherited renal factor may contribute to essential hypertension in humans, the study of family members is attractive. To assess the determinants of renal vascular tone, graded doses of either diltiazem (10-1000 micrograms/min) or acetylcholine (1-100 micrograms/min) were infused into the renal artery in 52 normotensive subjects, 16 with and 36 without a family history of hypertension...

Calcium channel antagonists have been shown to blunt maximal coronary flow after brief coronary occlusion and during pharmacologic coronary dilation in animals. This property, if present in humans, would result in a reduction in coronary flow reserve in the absence of intrinsic abnormalities of the coronary circulation. A reduction of maximal vasodilator capacity by calcium channel antagonists ...

In different animal models, photoreceptor degeneration was correlated to an abnormal increase in cGMP concentration. The cGMP-induced photoreceptor toxicity was demonstrated by applying the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine on retinal explants. To assess the role of cGMP-gated channels in this cGMP toxicity, the Ca(2+) channel blockers verapamil and L- and D-diltiazem, whi...