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April 1986, Vol 140, No. 4 >
Article | April 1986

Therapeutic Uses of Calcium Channel-Blocking Drugs in the Young FREE

Cornelia Cho, MD; Albert W. Pruitt, MD; James J. Corrigan, MD; Hugh D. Allen, MD; Richard Hong, MD; C. Thomas Kisker, MD
[+] Author Affiliations

Accepted for publication Dec 3, 1985.

Reprint requests to Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912 (Dr Pruitt).


Am J Dis Child. 1986;140(4):360-366. doi:10.1001/archpedi.1986.02140180094034.
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References
Comments

Calcium channel—blocking drugs, also referred to as calcium antagonists and slow-channel blockers, have had a major impact on the treatment of cardiovascular disorders such as angina, arrhythmias, and hypertension in adults. Although the drugs are labeled for use in only a limited number of pathologic conditions in children, clinical evaluations in a variety of illnesses are under way. Among the exciting potential uses are the treatment of asthma, control of premature labor, and as adjunctive therapy in cancer chemotherapy. The purpose of this report is to review research that has relevance to the therapeutic application of calcium channel blockers in the young.

PHARMACOLOGY  Calcium and its regulation are vital to a wide range of physiologic functions, including myocardial contractility, nerve impulse transmission, smooth-muscle contraction, and secretory activity of exocrine glands. An essential role for calcium was suggested by Ringer1,2 in 1883, when he demonstrated that the addition of calcium

REFERENCES

1 +
Ringer S:  A further contribution regarding the influence of different constituents of the blood on the contraction of the heart . J Physiol 1883;;4:29-43.
2 +
Ringer S:  Concerning experiments to test the influence of lime, sodium, and potassium salts on the development of ova and growth of tadpoles . J Physiol 1890;;11:79-84.
3 +
Katz AM, Hager WD, Messineo FC, et al:  Cellular actions and pharmacology of the calcium channel blocking drugs . Am J Med 1984;;77:2-10.
4 +
Fleckenstein A:  Specific pharmacology of calcium in myocardium, cardiac pacemakers, and vascular smooth muscle . Ann Rev Pharmacol Toxicol 1977;;17:149-166.
5 +
Katz AM:  Role of calcium in contraction of cardiac muscle , in Stone PH (ed): Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders . New York, Futura Publishing Co Inc, 1983;, pp 39-58.
6 +
Godfraind T:  Calcium influx and receptor-response coupling , in Weiss GB (ed): New Perspectives on Calcium Antagonists . Bethesda, Md, American Physiological Society, 1981;, pp 95-107.
7 +
Schwartz A, Triggle DJ:  Cellular action of calcium channel blocking drugs . Ann Rev Med 1984;;35:325-329.
8 +
Bein G, Wolf D:  The treatment of supraventricular paroxysmal tachycardia in infants and children with verapamil . Cardiol Pneumol 1971;;9:151.
9 +
Sapire DW, Mongkolsmai C, O'Riordan AC:  Control of ectopic supraventricular tachycardia with verapamil . J Pediatr 1979;;94:312-314.
10 +
Rinkenberger RL, Prystowsky EN, Heger JJ, et al:  Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias . Circulation 1980;; 62:996-1009.
11 +
Kashani IA, Shakibi JG, Siassi B:  Effect of verapamil on retrograde ventriculo-atrial conduction in children . Jpn Heart J 1980;;21:485-490.
12 +
Rozanski JJ, Zaman L, Castellanos A:  Electrophysiologic effects of diltiazem hydrochloride on supraventricular tachycardia . Am J Cardiol 1982;;49:621-628.
13 +
Betriu A, Chaitman BR, Bourassa MG, et al:  Beneficial effect of intravenous diltiazem in the acute management of paroxysmal supraventricular tachyarrhythmias . Circulation 1983;; 67:88-93.
14 +
Wolff F, Breuker KH, Schlensker KH, et al:  Prenatal diagnosis and therapy of fetal heart rate anomalies, with a contribution on the placental transfer of verapamil . J Perinat Med 1980;;8:203-207.
15 +
Truccone N, Mariona F:  Intrauterine conversion of fetal supraventricular tachycardia with combination of digoxin and verapamil . Pediatr Pharmacol 1985;;5:149-153.
16 +
Dilmen U, Caglar K, Senses A, et al:  Nifedipine in hypertensive emergencies of children . AJDC 1983;;137:1162-1165.
17 +
Frishman WH, Wineberg P, Peled H, et al:  Calcium entry blockers for the treatment of severe hypertension and hypertensive crisis . Am J Med 1984;;77:35-45.
18 +
Spicer RL, Rocchini AP, Crowley DC, et al:  Hemodynamic effects of verapamil in children and adolescents with hypertrophic cardiomyopathy . Circulation 1983;;67:413-419.
19 +
Rosing DR, Kent KM, Maron BJ, et al:  Verapamil therapy: A new approach to the pharmacologic treatment of hypertrophic cardiomyopathy . Circulation 1979;;60:1201-1213.
20 +
Kaltenbach M, Hopf R, Hober G, et al:  Treatment of hypertrophic obstructive cardiomyopathy with verapamil . Br Heart J 1979;;42:35-42.
21 +
Landmark K, Refsum AM, Simonsen S, et al:  Verapamil and pulmonary hypertension . Acta Med Scand 1978;;204:299-302.
22 +
Rubin U, Nicod P, Hillis LD, et al:  Treatment of primary pulmonary hypertension with nifedipine . Ann Intern Med 1983;;99:433-438.
23 +
Wise JR:  Nifedipine in the treatment of primary pulmonary hypertension . Am Heart J 1983;;105:693-694.
24 +
Camerini F, Alberti E, Klugman S, et al:  Primary pulmonary hypertension: Effects of nifedipine . Br Heart J 1980;;44:352-356.
25 +
Crevey BJ, Dantzker DR, Bower JS, et al:  Hemodynamic and gas exchange effects of intravenous diltiazem in patients with pulmonary hypertension . Am J Cardiol 1982;;49:578-583.
26 +
Kambara H, Fujimoto K, Wakabayashi A, et al:  Primary pulmonary hypertension: Beneficial therapy with diltiazem . Am Heart J 1981;;101: 230-231.
27 +
Henry PD:  Protection of ischemic myocardium by treatment with nifedipine , in Winbury MM, Akibo Y (eds): Ischemic Myocardium and Antianginal Drugs . New York, Raven Press, 1979;, pp 143-153.
28 +
Clark RE, Christlieb IY, Henry PD, et al:  Nifedipine: A myocardial protective agent . Am J Cardiol 1979;;44:825-831.
29 +
Nayler WG, Ferrari R, Williams A:  Protective effect of pretreatment with verapamil, nifedipine and propranalol on mitrochondrial function in the ischemic and reperfused myocardium . Am J Cardiol 1980;;46:242-248.
30 +
Waquier A, Fransen J, Clincke G, et al:  Calcium entry blockers as cerebral protecting agents , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 163-172.
31 +
Wellens D:  Twenty-seven calcium entry blockers in development: A new chapter in pharmacology , in Godfraind T (ed): Calcium Entry Blockers in Cardiovascular and Cerebral Dysfunctions . The Hague, Martinus Nijhoff Publishers, 1984;, pp 25-42.
32 +
Blaustein MP:  Barbiturates block calcium uptake by stimulated and potassium depolarized rat sympathetic ganglia . J Pharmacol Exp Ther 1976;;196:80-86.
33 +
Pincus JH, Lee SH:  Diphenylhydantoin and calcium: Relation to epinephrine release from brain slices . Arch Neurol 1973;;29:239-244.
34 +
Van den Bussche G, DeBeukelaar F, Waquier A:  Calcium-entry blockade and epilepsy , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 229-236.
35 +
Sohn RS, Ferrendelli JA:  Anticonvulsant drugs mechanism: Phenytoin, phenobarbital and ethosuximide and calcium flux in isolated presynaptic endings . Arch Neurol 1976;;33: 626-629.
36 +
Declerck AC, Wauquier A: Flunarizine: A double-blind study in therapy-resistant mentally retarded epileptic children, abstract No. 1615. Program and Abstracts of the Tenth Epilepsy International Symposium, 1978, Vancouver, Canada.
37 +
Overweg J, Binnie CD, Meijer JWA, et al:  Double-blind, placebo-controlled trial of flunarizine as add-on therapy in epilepsy . Epilepsia 1984;;25:217-222.
38 +
White BC, Winegar CD, Wilson RF, et al:  Possible role of calcium blockers in cerebral resuscitation: A review of the literature and synthesis for future studies . Crit Care Med 1983;;11: 202-207.
39 +
Hoffmeister F, Kazda S, Krause HP:  Influence of nimodipine (BAY E 9736) on the postischaemic changes of brain function . Acta Neurol Scand 1979;;60( (suppl 72) ):358-359.
40 +
Kazda S, Hoffmeister F, Garthoff B, et al:  Prevention of the postischaemic impaired reperfusion of the brain by nimodipine (BAY e 9736) . Acta Neurol Scand 1979;;60( (suppl 72) ):302-303.
41 +
White BC, Gadzinski DS, Hoehner PJ, et al:  Effect of flunarizine on canine cerebral cortical blood flow and vascular resistance post cardiac arrest . Ann Emerg Med 1982;;11:119-126.
42 +
Winegar CP, Henderson O, White BC, et al:  Early amelioration of neurological deficit by lidoflazine after 15 minutes of cardiopulmonary arrest in dogs . Ann Emerg Med 1983;;12:471-477.
43 +
Allen GS, Hyo SA, Preziosi TJ, et al:  Cerebral arterial spasm: Controlled trial of nimodipine in patients with subarachnoid hemorrhage . N Engl J Med 1983;;308:619-624.
44 +
Gelmers HJ:  Nimodipine, a new calcium antagonist, in the prophylactic treatment of migraine . Headache 1983;;23:106-109.
45 +
Meyer JS, Hardenberg J:  Clinical effectiveness of calcium entry blockers in prophylactic treatment of migraine and cluster headaches . Headache 1983;;23:266-277.
46 +
Smith R, Schwartz A:  Diltiazem prophylaxis in refractory migraine . N Engl J Med 1984;;310:1327-1328.
47 +
Amery WK:  Flunarizine, a calcium channel blocker: A new prophylactic drug in migraine . Headache 1983;;23:70-74.
48 +
McIntyre E, Fitzgibbon B, Otto H, et al:  Inhaled verapamil in histamine induced bronchoconstriction . J Allergy Clin Immunol 1983;;71: 375-381.
49 +
Patel KR, Al Shama MR, Kerr JW:  The effect of inhaled verapamil on allergen-induced bronchoconstriction . Clin Allergy 1983;;13: 119-122.
50 +
Emanuel MB, Chamberlain JA, Whiting S, et al:  Cinnarizine in the treatmentof chronic asthma . Br J Clin Pharmacol 1979;;7:189-195.
51 +
Cerrina J, Denjean A, Alexandre G, et al:  Inhibition of exercise-induced asthma by a calcium antagonist, nifedipine . Am Rev Respir Dis 1981;;123:156-160.
52 +
Henderson AF, Heaton RW, Dunlop LS, et al:  Effects of nifedipine on antigen-induced bronchoconstriction . Am Rev Respir Dis 1983;; 127:549-553.
53 +
Patakas D, Vlachoianni E, Tsara V, et al:  Nifedipine in bronchial asthma . J Allergy Clin Immunol 1983;;72:269-273.
54 +
Russi EW, Marchette B, Yerger L, et al:  Modification of allergic bronchoconstriction by a calcium antagonist: Mode of action . Am Rev Respir Dis 1983;;127:675-679.
55 +
Patel KR:  The effect of calcium antagonist, nifedipine, in exercise-induced asthma . Clin Allergy 1981;;11:429-432.
56 +
Forman A, Andersson K-E, Ulmsten U:  Inhibition of myometrial activity by calcium antagonists . Semin Perinatol 1981;;5:288-294.
57 +
Andersson K-E, Ulmsten U:  Effects of nifedipine on myometrial activity and lower abdominal pain in women with primary dysmenorrhea . Br J Obstet Gynaecol 1978;;85:142-148.
58 +
Bortolotti M, Labo G:  Clinical and manometric effects of nifedipine in patients with esophageal achalasia . Gastroenterology 1981;;80: 39-44.
59 +
Gelfond M, Rozen P, Gilat T:  Isosorbide dinitrate and nifedipine treatment of achalasia: A clinical, manometric and radionuclide evaluation . Gastroenterology 1982;;83:963-969.
60 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Increased accumulation of vincristine and adriamycin in drug-resistant P388 tumor cells following incubation with calcium antagonists and calmodulin inhibitors . Cancer Res 1982;;42: 4730-4733.
61 +
Tsuruo T, Iida H, Naganuma K, et al:  Promotion by verapamil of vincristine responsiveness in tumor cell lines inherently resistant to the drug . Cancer Res 1983;;43:808-813.
62 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Potentiation of vincristine and adriamycin effects in human hemopoietic tumor cell lines by calcium antagonists and calmodulin inhibitors . Cancer Res 1983;;43:2267-2272.
63 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Overcoming of vincristine resistance in P388 leukemia in vivo and in vitro through enhanced cytotoxicity of vincristine and vinblastine by verapamil . Cancer Res 1981;;41:1967-1972.
64 +
Tsuruo T, Iida H, Yamashiro M, et al:  Enhancement of vincristine and adriamycin-induced cytotoxicity by verapamil in P388 leukemia and its sublines resistant to vincristine and adriamycin . Biochem Pharmacol 1982;;31: 3138-3140.
65 +
Tsuruo T, Iida H, Nojiri M, et al:  Circumvention of vincristine and adriamycin resistance in vitro and in vivo by calcium influx blockers . Cancer Res 1983;;43:2905-2910.
66 +
Addonizio VP, Fisher CA, Strauss JF, et al:  Inhibition of human platelet function by verapamil . Thromb Res 1982;;28:545-556.
67 +
Han P, Boatwright C, Ardlie NG:  Inhibition of platelet function by antiarrhythmic drugs, verapamil and disopyramide . Thromb Haemost 1982;;47:150-153.
68 +
Barnathan ES, Addonizio VP, Shattil SJ:  Interaction of verapamil with human platelet alpha-adrenergic receptors . Am J Physiol 1982;;242:H19-H23.
69 +
Ikeda Y, Kikuchi M, Toyama K, et al:  Inhibition of human platelet functions by verapamil . Thromb Haemost 1981;;45:158-161.
70 +
Fuster V, Dewanjee MK, Murphy K, et al:  Role of verapamil (calcium blocker) in the reduction of platelet deposition in Gore-tex grafts in dogs , abstracted. Thromb Haemost 1981;;46:102.
71 +
Fleckenstein A, Frey M, Fleckenstein-Grun G:  Myocardial and vascular damage by intracellular calcium overload: Preventive actions of calcium antagonists , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 91-105.
72 +
DeFeudis FV:  'Calcium-antagonists' and atherosclerosis: Basic studies and therapeutic implications . Life Sci 1983;;32:557-563.
73 +
Betaz E, Hammerle H, Strohschneider T:  Inhibitory actions of calcium entry blockers on experimental atheromas , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 117-127.
74 +
Rodeheffer RJ, Rommer JA, Wigley F, et al:  Controlled double-blind trial of nifedipine in the treatment of Raynaud's phenomenon . N Engl J Med 1983;;308:880-883.
75 +
Smith CD, McKendry RJR:  Controlled trial of nifedipine in the treatment of Raynaud's phenomenon . Lancet 1982;;2:1299-1301.
76 +
Taniguchi H, Murakami K, Morita S, et al:  Calcium antagonist (diltiazem) for reversal of hypoglycaemic symptoms in insulinoma . Lancet 1977;;2:501.
77 +
DeMarinis L, Barbarino A:  Calcium antagonists and hormone release: I. Effects of verapamil on insulin release in normal subjects and patients with islet-cell tumor . Metabolism 1980;;29:599-604.
78 +
Andersson DEH, Rodjmark S:  Improvement of glucose tolerance by verapamil in patients with non—insulin-dependent diabetes mellitus . Acta Med Scand 1981;;210:27-33.
79 +
Epstein SE, Rosing DR:  Verapamil: Its potential for causing serious complications in patients with hypertrophic cardiomyopathy . Circulation 1981;;64:437-441.
80 +
Packer M, Meller J, Medina N, et al:  Hemodynamic consequences of combined beta-adrenergic and slow calcium channel blockade in man . Circulation 1982;;65:660-668.
81 +
Krikler DM, Spurrel RAJ:  Verapamil in the treatment of paroxysmal supraventricular tachycardia . Postgrad Med J 1974;;50:447-453.
82 +
Benaim ME:  Asystole after verapamil . Br Med J 1972;;2:169.
83 +
Boothby CB, Garrard CS, Pickering D:  Intravenous verapamil in cardiac arrhythmias . Br Med J 1972;;2:349.
84 +
Seabro-Gomes R, Richards A, Sutton R:  Hemodynamic effects of verapamil and practolol in man . Eur J Cardiol 1976;;4:79-85.
85 +
Epstein ML, Kiel EA, Victorica BJ:  Cardiac decompensation following verapamil therapy in infants with supraventricular tachycardia . Pediatrics 1985;;75:737-740.
86 +
Radford D:  Side effects of verapamil in infants . Arch Dis Child 1983;;58:465-466.
87 +
Abinader E, Borochowitz Z, Berger A:  A hemodynamic complication of verapamil therapy in a neonate . Helv Paediatr Acta 1981;;36:451-455.
88 +
Lewis JG:  Adverse reactions to calcium antagonists . Drugs 1983;;25:196-222.
89 +
Nobile-Orazio E, Sterzi R:  Cerebral ischemia after nifedipine treatment . Br Med J 1981;;283:948.
90 +
Brink DD:  Diltiazem and hyperactivity . Ann Intern Med 1984;;100:459-460.
91 +
Ward DJ, Ward JW, Griffo W, et al:  Intravenous calcium for fecal impaction secondary to verapamil . N Engl J Med 1982;;307:1709-1710.
92 +
Stern EH, Pitchon R, King BD, et al:  Possible hepatitis from verapamil . N Engl J Med 1982;;306:1012-1013.
93 +
Antman EM, Horowitz J, Stone PH:  Clinical pharmacology of the calcium channel blocking agents , in Stone PH, Antman EM (eds): Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders . New York, Futura Publishing Co Inc, 1983;, pp 177-201.
94 +
Wagner JG, Rocchini AP, Vasiliades J:  Prediction of steady-state verapamil plasma concentration in children and adults . Clin Pharmacol Ther 1982;;32:172-181.
95 +
Woodcock BG, Rietbrock I, Vohringer HF, et al:  Verapamil disposition in liver disease and intensive care patients: Kinetics, clearance, and apparent blood flow relationships . Clin Pharmacol Ther 1981;;29:27-34.
96 +
Somogyi A, Albrecht M, Kleims G, et al:  Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis . Br J Clin Pharmacol 1981;;12:51-60.
97 +
Pedersen KE, Dorph-Pedersen A, Hvidt S, et al:  Digoxin-verapamil interaction . Clin Pharmacol Ther 1981;;30:311-336.
98 +
Klein HO, Lang R, Weiss E, et al:  The influence of verapamil on serum digoxin concentration . Circulation 1982;;65:998-1003.
99 +
Klein HO, Lang R, Kaplinsky E:  Verapamil-digoxin interaction . N Engl J Med 1980;;303:160.

Figures

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Ringer S:  A further contribution regarding the influence of different constituents of the blood on the contraction of the heart . J Physiol 1883;;4:29-43.
2 +
Ringer S:  Concerning experiments to test the influence of lime, sodium, and potassium salts on the development of ova and growth of tadpoles . J Physiol 1890;;11:79-84.
3 +
Katz AM, Hager WD, Messineo FC, et al:  Cellular actions and pharmacology of the calcium channel blocking drugs . Am J Med 1984;;77:2-10.
4 +
Fleckenstein A:  Specific pharmacology of calcium in myocardium, cardiac pacemakers, and vascular smooth muscle . Ann Rev Pharmacol Toxicol 1977;;17:149-166.
5 +
Katz AM:  Role of calcium in contraction of cardiac muscle , in Stone PH (ed): Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders . New York, Futura Publishing Co Inc, 1983;, pp 39-58.
6 +
Godfraind T:  Calcium influx and receptor-response coupling , in Weiss GB (ed): New Perspectives on Calcium Antagonists . Bethesda, Md, American Physiological Society, 1981;, pp 95-107.
7 +
Schwartz A, Triggle DJ:  Cellular action of calcium channel blocking drugs . Ann Rev Med 1984;;35:325-329.
8 +
Bein G, Wolf D:  The treatment of supraventricular paroxysmal tachycardia in infants and children with verapamil . Cardiol Pneumol 1971;;9:151.
9 +
Sapire DW, Mongkolsmai C, O'Riordan AC:  Control of ectopic supraventricular tachycardia with verapamil . J Pediatr 1979;;94:312-314.
10 +
Rinkenberger RL, Prystowsky EN, Heger JJ, et al:  Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias . Circulation 1980;; 62:996-1009.
11 +
Kashani IA, Shakibi JG, Siassi B:  Effect of verapamil on retrograde ventriculo-atrial conduction in children . Jpn Heart J 1980;;21:485-490.
12 +
Rozanski JJ, Zaman L, Castellanos A:  Electrophysiologic effects of diltiazem hydrochloride on supraventricular tachycardia . Am J Cardiol 1982;;49:621-628.
13 +
Betriu A, Chaitman BR, Bourassa MG, et al:  Beneficial effect of intravenous diltiazem in the acute management of paroxysmal supraventricular tachyarrhythmias . Circulation 1983;; 67:88-93.
14 +
Wolff F, Breuker KH, Schlensker KH, et al:  Prenatal diagnosis and therapy of fetal heart rate anomalies, with a contribution on the placental transfer of verapamil . J Perinat Med 1980;;8:203-207.
15 +
Truccone N, Mariona F:  Intrauterine conversion of fetal supraventricular tachycardia with combination of digoxin and verapamil . Pediatr Pharmacol 1985;;5:149-153.
16 +
Dilmen U, Caglar K, Senses A, et al:  Nifedipine in hypertensive emergencies of children . AJDC 1983;;137:1162-1165.
17 +
Frishman WH, Wineberg P, Peled H, et al:  Calcium entry blockers for the treatment of severe hypertension and hypertensive crisis . Am J Med 1984;;77:35-45.
18 +
Spicer RL, Rocchini AP, Crowley DC, et al:  Hemodynamic effects of verapamil in children and adolescents with hypertrophic cardiomyopathy . Circulation 1983;;67:413-419.
19 +
Rosing DR, Kent KM, Maron BJ, et al:  Verapamil therapy: A new approach to the pharmacologic treatment of hypertrophic cardiomyopathy . Circulation 1979;;60:1201-1213.
20 +
Kaltenbach M, Hopf R, Hober G, et al:  Treatment of hypertrophic obstructive cardiomyopathy with verapamil . Br Heart J 1979;;42:35-42.
21 +
Landmark K, Refsum AM, Simonsen S, et al:  Verapamil and pulmonary hypertension . Acta Med Scand 1978;;204:299-302.
22 +
Rubin U, Nicod P, Hillis LD, et al:  Treatment of primary pulmonary hypertension with nifedipine . Ann Intern Med 1983;;99:433-438.
23 +
Wise JR:  Nifedipine in the treatment of primary pulmonary hypertension . Am Heart J 1983;;105:693-694.
24 +
Camerini F, Alberti E, Klugman S, et al:  Primary pulmonary hypertension: Effects of nifedipine . Br Heart J 1980;;44:352-356.
25 +
Crevey BJ, Dantzker DR, Bower JS, et al:  Hemodynamic and gas exchange effects of intravenous diltiazem in patients with pulmonary hypertension . Am J Cardiol 1982;;49:578-583.
26 +
Kambara H, Fujimoto K, Wakabayashi A, et al:  Primary pulmonary hypertension: Beneficial therapy with diltiazem . Am Heart J 1981;;101: 230-231.
27 +
Henry PD:  Protection of ischemic myocardium by treatment with nifedipine , in Winbury MM, Akibo Y (eds): Ischemic Myocardium and Antianginal Drugs . New York, Raven Press, 1979;, pp 143-153.
28 +
Clark RE, Christlieb IY, Henry PD, et al:  Nifedipine: A myocardial protective agent . Am J Cardiol 1979;;44:825-831.
29 +
Nayler WG, Ferrari R, Williams A:  Protective effect of pretreatment with verapamil, nifedipine and propranalol on mitrochondrial function in the ischemic and reperfused myocardium . Am J Cardiol 1980;;46:242-248.
30 +
Waquier A, Fransen J, Clincke G, et al:  Calcium entry blockers as cerebral protecting agents , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 163-172.
31 +
Wellens D:  Twenty-seven calcium entry blockers in development: A new chapter in pharmacology , in Godfraind T (ed): Calcium Entry Blockers in Cardiovascular and Cerebral Dysfunctions . The Hague, Martinus Nijhoff Publishers, 1984;, pp 25-42.
32 +
Blaustein MP:  Barbiturates block calcium uptake by stimulated and potassium depolarized rat sympathetic ganglia . J Pharmacol Exp Ther 1976;;196:80-86.
33 +
Pincus JH, Lee SH:  Diphenylhydantoin and calcium: Relation to epinephrine release from brain slices . Arch Neurol 1973;;29:239-244.
34 +
Van den Bussche G, DeBeukelaar F, Waquier A:  Calcium-entry blockade and epilepsy , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 229-236.
35 +
Sohn RS, Ferrendelli JA:  Anticonvulsant drugs mechanism: Phenytoin, phenobarbital and ethosuximide and calcium flux in isolated presynaptic endings . Arch Neurol 1976;;33: 626-629.
36 +
Declerck AC, Wauquier A: Flunarizine: A double-blind study in therapy-resistant mentally retarded epileptic children, abstract No. 1615. Program and Abstracts of the Tenth Epilepsy International Symposium, 1978, Vancouver, Canada.
37 +
Overweg J, Binnie CD, Meijer JWA, et al:  Double-blind, placebo-controlled trial of flunarizine as add-on therapy in epilepsy . Epilepsia 1984;;25:217-222.
38 +
White BC, Winegar CD, Wilson RF, et al:  Possible role of calcium blockers in cerebral resuscitation: A review of the literature and synthesis for future studies . Crit Care Med 1983;;11: 202-207.
39 +
Hoffmeister F, Kazda S, Krause HP:  Influence of nimodipine (BAY E 9736) on the postischaemic changes of brain function . Acta Neurol Scand 1979;;60( (suppl 72) ):358-359.
40 +
Kazda S, Hoffmeister F, Garthoff B, et al:  Prevention of the postischaemic impaired reperfusion of the brain by nimodipine (BAY e 9736) . Acta Neurol Scand 1979;;60( (suppl 72) ):302-303.
41 +
White BC, Gadzinski DS, Hoehner PJ, et al:  Effect of flunarizine on canine cerebral cortical blood flow and vascular resistance post cardiac arrest . Ann Emerg Med 1982;;11:119-126.
42 +
Winegar CP, Henderson O, White BC, et al:  Early amelioration of neurological deficit by lidoflazine after 15 minutes of cardiopulmonary arrest in dogs . Ann Emerg Med 1983;;12:471-477.
43 +
Allen GS, Hyo SA, Preziosi TJ, et al:  Cerebral arterial spasm: Controlled trial of nimodipine in patients with subarachnoid hemorrhage . N Engl J Med 1983;;308:619-624.
44 +
Gelmers HJ:  Nimodipine, a new calcium antagonist, in the prophylactic treatment of migraine . Headache 1983;;23:106-109.
45 +
Meyer JS, Hardenberg J:  Clinical effectiveness of calcium entry blockers in prophylactic treatment of migraine and cluster headaches . Headache 1983;;23:266-277.
46 +
Smith R, Schwartz A:  Diltiazem prophylaxis in refractory migraine . N Engl J Med 1984;;310:1327-1328.
47 +
Amery WK:  Flunarizine, a calcium channel blocker: A new prophylactic drug in migraine . Headache 1983;;23:70-74.
48 +
McIntyre E, Fitzgibbon B, Otto H, et al:  Inhaled verapamil in histamine induced bronchoconstriction . J Allergy Clin Immunol 1983;;71: 375-381.
49 +
Patel KR, Al Shama MR, Kerr JW:  The effect of inhaled verapamil on allergen-induced bronchoconstriction . Clin Allergy 1983;;13: 119-122.
50 +
Emanuel MB, Chamberlain JA, Whiting S, et al:  Cinnarizine in the treatmentof chronic asthma . Br J Clin Pharmacol 1979;;7:189-195.
51 +
Cerrina J, Denjean A, Alexandre G, et al:  Inhibition of exercise-induced asthma by a calcium antagonist, nifedipine . Am Rev Respir Dis 1981;;123:156-160.
52 +
Henderson AF, Heaton RW, Dunlop LS, et al:  Effects of nifedipine on antigen-induced bronchoconstriction . Am Rev Respir Dis 1983;; 127:549-553.
53 +
Patakas D, Vlachoianni E, Tsara V, et al:  Nifedipine in bronchial asthma . J Allergy Clin Immunol 1983;;72:269-273.
54 +
Russi EW, Marchette B, Yerger L, et al:  Modification of allergic bronchoconstriction by a calcium antagonist: Mode of action . Am Rev Respir Dis 1983;;127:675-679.
55 +
Patel KR:  The effect of calcium antagonist, nifedipine, in exercise-induced asthma . Clin Allergy 1981;;11:429-432.
56 +
Forman A, Andersson K-E, Ulmsten U:  Inhibition of myometrial activity by calcium antagonists . Semin Perinatol 1981;;5:288-294.
57 +
Andersson K-E, Ulmsten U:  Effects of nifedipine on myometrial activity and lower abdominal pain in women with primary dysmenorrhea . Br J Obstet Gynaecol 1978;;85:142-148.
58 +
Bortolotti M, Labo G:  Clinical and manometric effects of nifedipine in patients with esophageal achalasia . Gastroenterology 1981;;80: 39-44.
59 +
Gelfond M, Rozen P, Gilat T:  Isosorbide dinitrate and nifedipine treatment of achalasia: A clinical, manometric and radionuclide evaluation . Gastroenterology 1982;;83:963-969.
60 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Increased accumulation of vincristine and adriamycin in drug-resistant P388 tumor cells following incubation with calcium antagonists and calmodulin inhibitors . Cancer Res 1982;;42: 4730-4733.
61 +
Tsuruo T, Iida H, Naganuma K, et al:  Promotion by verapamil of vincristine responsiveness in tumor cell lines inherently resistant to the drug . Cancer Res 1983;;43:808-813.
62 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Potentiation of vincristine and adriamycin effects in human hemopoietic tumor cell lines by calcium antagonists and calmodulin inhibitors . Cancer Res 1983;;43:2267-2272.
63 +
Tsuruo T, Iida H, Tsukagoshi S, et al:  Overcoming of vincristine resistance in P388 leukemia in vivo and in vitro through enhanced cytotoxicity of vincristine and vinblastine by verapamil . Cancer Res 1981;;41:1967-1972.
64 +
Tsuruo T, Iida H, Yamashiro M, et al:  Enhancement of vincristine and adriamycin-induced cytotoxicity by verapamil in P388 leukemia and its sublines resistant to vincristine and adriamycin . Biochem Pharmacol 1982;;31: 3138-3140.
65 +
Tsuruo T, Iida H, Nojiri M, et al:  Circumvention of vincristine and adriamycin resistance in vitro and in vivo by calcium influx blockers . Cancer Res 1983;;43:2905-2910.
66 +
Addonizio VP, Fisher CA, Strauss JF, et al:  Inhibition of human platelet function by verapamil . Thromb Res 1982;;28:545-556.
67 +
Han P, Boatwright C, Ardlie NG:  Inhibition of platelet function by antiarrhythmic drugs, verapamil and disopyramide . Thromb Haemost 1982;;47:150-153.
68 +
Barnathan ES, Addonizio VP, Shattil SJ:  Interaction of verapamil with human platelet alpha-adrenergic receptors . Am J Physiol 1982;;242:H19-H23.
69 +
Ikeda Y, Kikuchi M, Toyama K, et al:  Inhibition of human platelet functions by verapamil . Thromb Haemost 1981;;45:158-161.
70 +
Fuster V, Dewanjee MK, Murphy K, et al:  Role of verapamil (calcium blocker) in the reduction of platelet deposition in Gore-tex grafts in dogs , abstracted. Thromb Haemost 1981;;46:102.
71 +
Fleckenstein A, Frey M, Fleckenstein-Grun G:  Myocardial and vascular damage by intracellular calcium overload: Preventive actions of calcium antagonists , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 91-105.
72 +
DeFeudis FV:  'Calcium-antagonists' and atherosclerosis: Basic studies and therapeutic implications . Life Sci 1983;;32:557-563.
73 +
Betaz E, Hammerle H, Strohschneider T:  Inhibitory actions of calcium entry blockers on experimental atheromas , in Godfraind T (ed): Calcium Entry Blockers and Tissue Protection . New York, Raven Press, 1985;, pp 117-127.
74 +
Rodeheffer RJ, Rommer JA, Wigley F, et al:  Controlled double-blind trial of nifedipine in the treatment of Raynaud's phenomenon . N Engl J Med 1983;;308:880-883.
75 +
Smith CD, McKendry RJR:  Controlled trial of nifedipine in the treatment of Raynaud's phenomenon . Lancet 1982;;2:1299-1301.
76 +
Taniguchi H, Murakami K, Morita S, et al:  Calcium antagonist (diltiazem) for reversal of hypoglycaemic symptoms in insulinoma . Lancet 1977;;2:501.
77 +
DeMarinis L, Barbarino A:  Calcium antagonists and hormone release: I. Effects of verapamil on insulin release in normal subjects and patients with islet-cell tumor . Metabolism 1980;;29:599-604.
78 +
Andersson DEH, Rodjmark S:  Improvement of glucose tolerance by verapamil in patients with non—insulin-dependent diabetes mellitus . Acta Med Scand 1981;;210:27-33.
79 +
Epstein SE, Rosing DR:  Verapamil: Its potential for causing serious complications in patients with hypertrophic cardiomyopathy . Circulation 1981;;64:437-441.
80 +
Packer M, Meller J, Medina N, et al:  Hemodynamic consequences of combined beta-adrenergic and slow calcium channel blockade in man . Circulation 1982;;65:660-668.
81 +
Krikler DM, Spurrel RAJ:  Verapamil in the treatment of paroxysmal supraventricular tachycardia . Postgrad Med J 1974;;50:447-453.
82 +
Benaim ME:  Asystole after verapamil . Br Med J 1972;;2:169.
83 +
Boothby CB, Garrard CS, Pickering D:  Intravenous verapamil in cardiac arrhythmias . Br Med J 1972;;2:349.
84 +
Seabro-Gomes R, Richards A, Sutton R:  Hemodynamic effects of verapamil and practolol in man . Eur J Cardiol 1976;;4:79-85.
85 +
Epstein ML, Kiel EA, Victorica BJ:  Cardiac decompensation following verapamil therapy in infants with supraventricular tachycardia . Pediatrics 1985;;75:737-740.
86 +
Radford D:  Side effects of verapamil in infants . Arch Dis Child 1983;;58:465-466.
87 +
Abinader E, Borochowitz Z, Berger A:  A hemodynamic complication of verapamil therapy in a neonate . Helv Paediatr Acta 1981;;36:451-455.
88 +
Lewis JG:  Adverse reactions to calcium antagonists . Drugs 1983;;25:196-222.
89 +
Nobile-Orazio E, Sterzi R:  Cerebral ischemia after nifedipine treatment . Br Med J 1981;;283:948.
90 +
Brink DD:  Diltiazem and hyperactivity . Ann Intern Med 1984;;100:459-460.
91 +
Ward DJ, Ward JW, Griffo W, et al:  Intravenous calcium for fecal impaction secondary to verapamil . N Engl J Med 1982;;307:1709-1710.
92 +
Stern EH, Pitchon R, King BD, et al:  Possible hepatitis from verapamil . N Engl J Med 1982;;306:1012-1013.
93 +
Antman EM, Horowitz J, Stone PH:  Clinical pharmacology of the calcium channel blocking agents , in Stone PH, Antman EM (eds): Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders . New York, Futura Publishing Co Inc, 1983;, pp 177-201.
94 +
Wagner JG, Rocchini AP, Vasiliades J:  Prediction of steady-state verapamil plasma concentration in children and adults . Clin Pharmacol Ther 1982;;32:172-181.
95 +
Woodcock BG, Rietbrock I, Vohringer HF, et al:  Verapamil disposition in liver disease and intensive care patients: Kinetics, clearance, and apparent blood flow relationships . Clin Pharmacol Ther 1981;;29:27-34.
96 +
Somogyi A, Albrecht M, Kleims G, et al:  Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis . Br J Clin Pharmacol 1981;;12:51-60.
97 +
Pedersen KE, Dorph-Pedersen A, Hvidt S, et al:  Digoxin-verapamil interaction . Clin Pharmacol Ther 1981;;30:311-336.
98 +
Klein HO, Lang R, Weiss E, et al:  The influence of verapamil on serum digoxin concentration . Circulation 1982;;65:998-1003.
99 +
Klein HO, Lang R, Kaplinsky E:  Verapamil-digoxin interaction . N Engl J Med 1980;;303:160.

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