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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We hypothesized that verapamil and nifedipine would potentiate the cardiac toxicity of magnesium in a dose-dependent manner. The hypothesis was tested in the isolated perfused rat heart model (Langendorff's apparatus) with Sprague-Dawley rats. After excision of hearts, each heart was exposed to increasing doses of verapamil and nifedipine followed by magnesium sulfate. Heart rate, contractility, and left ventricular systolic pressure were measured. Nifedipine and verapamil infusion in this model caused dose-dependent decreases in all three parameters measured (p values 0.05 to 0.01). The addition of magnesium sulfate potentiated these dose-dependent decreases (p values 0.01 to 0.0002). Nifedipine and verapamil caused similar depression at equivalent doses. Nifedipine and verapamil cause dose-dependent cardiac depression that is potentiated by the addition of magnesium sulfate in the isolated perfused rat heart. Caution is called for when magnesium sulfate and calcium channel blockers are administered in combination.
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PMID:Do nifedipine and verapamil potentiate the cardiac toxicity of magnesium sulfate? 826 11

We evaluated postoperative pain relief and incidence of side effects of the combination of epidural morphine (0.5 mg) and sublingual nifedipine (10 mg). Thirty-six patients were submitted to elective operations and divided into 4 groups receiving placebo (groups A and B) or morphine (groups C and D) by the epidural route, followed by sublingual placebo (groups A and C) or nifedipine (groups B and D) administered in a double-blind fashion. The mean (+/- S.E.M.) periods of analgesia were 16.6 +/- 1.6 (A), 15 (B) 105 +/- 77.0 (C), and 428.8 +/- 72.0 (D) min. No patient had pruritus, excessive sedation or respiratory depression. Episodes of nausea and/or vomiting requiring no specific therapy were observed in groups A, B and D. Nifedipine-treated groups also had a significant fall in blood pressure which was controlled by rehydration. These results indicate that epidural morphine-induced postoperative pain relief may be enhanced by systemic administration of nifedipine, with easily controlled side effects.
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PMID:Enhancement of the epidural morphine-induced analgesia by systemic nifedipine. 835 Nov 63

We evaluated the acute therapeutic effects of the oral administration of nifedipine (10 mg) and diltiazem (120 mg) alone and in combination in 16 patients with effort angina. The 16 patients (13 men and three women; mean age 59 +/- 7 years) performed a symptom-limited bicycle exercise stress test 3 h after placebo or active substance administration. Maximal work load, exercise duration and time to 1 mm ST segment depression were significantly increased and ST depression at peak exercise was significantly decreased by the combination of drugs. Nifedipine and diltiazem alone similarly improved exercise duration as markedly as their combination. One patient stopped the test after all three treatments for angina associated with ST depression > 2 mm. The combination of drugs yielded the best symptomatic effect: only four patients complained of angina in comparison to eight and seven patients after diltiazem and nifedipine, respectively. Nifedipine and diltiazem are effective and safe antianginal drugs. Some patients respond better to one drug than to the other. Patients who remain symptomatic in spite of maximal doses of a single drug may derive some benefit from combination therapy.
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PMID:Acute effects of nifedipine, diltiazem and their combination in patients with chronic stable angina: a double-blind, randomized, cross-over, placebo-controlled study. 845 64

To study the anti-ischemic effect of slow-release nifedipine ten patients with stable angina pectoris and a positive effort test were selected. Nifedipinemia was measured by a gas chromatographic method. At the peak level of effort intensity slow-release nifedipine significantly decreased the mean ST-segment depression (p < 0.05) and the ischemic score (p < 0.01) when compared to the control effort test, without decreasing the double product. Nifedipine induced no more tachycardia additional to that produced by effort. At the beginning of the effort test the level of nifedipine (15.9 +/- 2.51 ng/ml) was superior to the value considered as minimal effective and was positively correlated with the ischemic score (r = 0.67; p < 0.05). A worsening of ischemia was noted in 2 patients probably due to a steal phenomenon.
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PMID:The effect of slow-release nifedipine on ST-segment depression induced by effort test. Correlations with serum levels. 864 88

The efficacy of nifedipine gastrointestinal therapeutic system (GITS), 60-90 mg o.d., isosorbide dinitrate, 40-60 mg b.d., and isosorbide mononitrate slow-release, 50-100 mg o.d. was assessed in a six week double-blind, parallel-group study in patients with stable angina on chronic beta-blocker treatment. Of 339 patients who entered the study, 229 were eligible for the valid case analysis of efficacy and 335 for the safety analysis. Nifedipine GITS was significantly better than isosorbide dinitrate (P < or = 0.025) in prolonging time to 1 mm ST-segment depression, time to maximum ST-segment depression, time to occurrence of angina and total exercise duration, in addition to reducing the number of angina attacks and glyceryl trinitrate consumption after six weeks therapy. Nifedipine GITS was also significantly better than isosorbide mononitrate (P < or = 0.025) in prolonging time to occurrence of angina and time to 1 mm ST-segment depression after six weeks therapy. The incidence of headache was considerably higher in both the isosorbide dinitrate and isosorbide mononitrate groups (40% and 41%, respectively) than in the nifedipine GITS group (9.5%, P < or = 0.001), and was the main reason for withdrawal from the study (isosorbide dinitrate 18/99, isosorbide mononitrate 17/99, nifedipine GITS 2/95). Peripheral oedema was more common in patients treated with nifedipine GITS (12.5%) compared to nitrates (2% in both groups, P < or = 0.01), but resulted in withdrawal of only one patient (treated with nifedipine GITS). This study suggests that the efficacy and tolerability of nifedipine GITS is superior to long acting nitrates as second-line therapy to beta-blockade in the treatment of chronic stable angina.
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PMID:A comparison of nifedipine once daily (Adalat LA), isosorbide mononitrate once daily, and isosorbide dinitrate twice daily in patients with chronic stable angina. 943 70

1. The aim of this study was to assess the role of tachykinins, acting via NK1 and NK2 receptors, in mediating nonadrenergic noncholinergic (NANC) contractions produced by electrical field stimulation (EFS) in the circular muscle of the rat small intestine. 2. In the presence of atropine (1 microM), guanethidine (3 microM), indomethacin (10 microM), apamin (0.3 microM) and L-nitroarginine (L-NOARG, 100 microM) and after in vitro capsaicin (10 microM for 15 min) pretreatment, EFS (0.25 ms pulse width, 100 V, 1-30 Hz for 5 s) produced a frequency-dependent NANC contraction of mucosa-free circular muscle strips from the rat proximal duodenum and terminal ileum. In the duodenum, the NANC contraction was preceded by a transient NANC relaxation. All responses to EFS were abolished by 1 microM tetrodotoxin. 3. The NK1 receptor selective antagonist, SR 140,333 (0.1 microM for 60 min) and the NK2 receptor selective antagonist, MEN 10,627 (0.1 microM for 60 min), both produced a partial inhibition of the contractile response to EFS. The co-administration of SR 140,333 and MEN 10,627 produced a profound inhibition of the response to EFS in the duodenum, larger than that produced by each antagonist alone; a fraction (about 25% of the response at 30 Hz) of the NANC contraction of the duodenum persisted in the presence of the two antagonists. This residual response was however abolished after co-administration of the NK1 and NK2 receptor antagonists, GR 94,800 (1 microM) and GR 82,334 (10 microM). The co-administration of SR 140,333 and MEN 10,627 nearly abolished the NANC contraction to EFS in the ileum. 4. Nifedipine (1 microM) induced a profound depression of the NANC contraction to EFS in both duodenal and ileal strips. A fraction of the response to EFS (about 25 and 5-10% of the response at 30 Hz in the duodenum and ileum, respectively) was nifedipine-resistant. SR 140,333 (0.1 microM) had little effect on the nifedipine-resistant response to EFS in the duodenum although it reduced by about 50% the response in the ileum. MEN 10,627 (0.1 microM) produced a partial inhibitory effect of the nifedipine-resistant response in both regions. The co-administration of SR 140,333 and MEN 10,627 nearly abolished the nifedipine-resistant response in the ileum while a small fraction (about 20% of control) of the response persisted in the duodenum.
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PMID:Role of tachykinins as excitatory mediators of NANC contraction in the circular muscle of rat small intestine. 874 74

This was a double-blind, within-patient, crossover study to evaluate the effects of a new formulation of metoprolol on blood pressure (BP) and myocardial ischemia. Twenty outpatients with mild to moderate essential arterial hypertension, chronic stable angina pectoris and positive exercise test, after a 2-week baseline placebo period, were randomized to receive long-acting metoprolol (OROS) 14/190 mg o.d., nifedipine SR 20 mg b.i.d. or their combination in a sequence of a 3 x 3 Latin square design. Two patients withdrew from the study (1 for adverse event during metoprolol and 1 for rise of BP during nifedipine). Nifedipine, metoprolol and their combination significantly reduced the weekly number of angina attacks and nitroglycerin consumption with respect to baseline. The total number of ischemic events (at 24-hour ECG monitoring) significantly decreased after each treatment with respect to baseline. Twenty-four hours mean systolic and diastolic BP were reduced by both nifedipine alone and metoprolol alone; the combination of the two drugs led to a further decrease in both systolic and diastolic BP. The duration of silent ischemic episodes was significantly reduced by nifedipine and combination but not by metoprolol. On the other hand 24 hours symptomatic attacks/patient were significantly reduced by beta-blocker and combination, but not by nifedipine. Metoprolol alone and administered with nifedipine caused a decrease, with respect to placebo baseline, in 24-hour mean heart rate (HR) and reduced the increase of HR and systolic BP at the onset of ST depression during symptomatic ischemic episodes. The effort time and time to ST = -1 mm at treadmill were significantly increased by treatment with nifedipine alone, with metoprolol alone and with their combination, but the combination was more effective than the individual therapies. ST depression at peak exercise was significantly reduced by each treatment. The slopes of correlations between the ST-segment variation and systolic BP, HR and rate-pressure product during exercise, significantly decreased after all treatments with respect to placebo baseline, more with the combination therapy than with nifedipine alone and metoprolol alone. In conclusion, based on our results the favourable interaction of metoprolol OROS and nifedipine given concomitantly, is likely to be due to a better control, respect to each individual therapy, of the pathogenetic mechanism of myocardia ischemia: BP and HR increases during exercise and during symptomatic ischemic episodes are controlled by the beta-blocker and coronary vasoconstriction during silent ischemia is prevented by the calcium-antagonist.
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PMID:Treatment of hypertension associated with stable angina pectoris: favourable interaction between new metoprolol formulation (OROS) and nifedipine. 883 Nov 81

1. We have investigated the effect of various protein kinase A (PKA) inhibitors on the phasic and tonic components of the response to potassium chloride (KCl) in the guinea pig ureter. All experiments were performed in ureters pretreated with capsaicin (10 microM for 15 min) to prevent the release of sensory neuropeptides and in the presence of 1 microM Bay K 8644 to maximize calcium (Ca) entry via voltage-sensitive channels. The addition of 80 mM hypertonic KCl produced maximal shortening of the ureter with distinct phasic and tonic components, the latter further showing a transient and a sustained component. Nifedipine (30 microM for 120 min) totally abolished all the responses to KCl. 2. The selective PKA inhibitor, H89 (10 microM), abolished the tonic response to KCl in about 30 min with minor inhibitory effect on the phasic contraction. This pattern was unchanged when extending the contact time to 120 min. When added 30 min before the next challenge, H89 (1-30 microM) concentration-dependently inhibited the responses to KCl with a preferential inhibitory effect on the tonic contraction. Another PKA inhibitor, H8, produced similar effects at tenfold higher concentrations (10-300 microM) than H89, consistent with the known potency ratio of these isoquinoline derivatives in inhibiting PKA. 3. The potent and nonselective protein kinase inhibitor, staurosporine (10-100 nM) produced an even depression of the various phases of the response to KCl. The selective protein kinase G inhibitor, KT 5823 (10 microM for 60 min) produced only a slight reduction of the sustained tonic response to KCl. The selective protein kinase C inhibitor GF 109,203X (1-3 microM) and the cAMP analog, Rp-cAMPS (300 microM for 60 min) had no effect on the three components of the response to KCl. 4. In the presence of Bay K 8644, electrical field stimulation (10 Hz for 1 sec, 60 V, pulse width 5 ms) produces direct myogenic phasic contractions (twitches) of the ureter which are suppressed by nifedipine (10-30 microM). H8 (up to 30 microM) and H89 (up to 300 microM) had minor effect on the amplitude of twitches, consistent with their poor inhibitory activity on the phasic responses to KCl. 5. In sucrose gap, superfusion with 80 mM hypertonic KCl produced action potentials followed by a sustained depolarization of the membrane: the two electrical responses underlie the phasic and tonic components of contraction to KCl, respectively. H89 (10 microM for 30 min) did not affect the resting membrane potential nor the KCl-evoked action potentials and sustained depolarization. H89 had no effect on the phasic contraction to KCl but markedly depressed (about 65% inhibition) the tonic contraction. 6. The present findings are consistent with the view that phosphorylation by PKA increases the availability of L-type Ca channels in the ureter smooth muscle. Blockade of PKA dissociates the electromechanical coupling between the sustained membrane depolarization produced by KCl and the corresponding sustained increase in tension. The L-type Ca channel responsible for generating action potentials and phasic contractions to KCl are less sensitive to PKA inhibitors than those responsible for the tonic contraction.
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PMID:Protein kinase A inhibitors selectively inhibit the tonic contraction of the guinea pig ureter to high potassium. 891 54

Nerve muscle preparation of Setaria cervi (Nematoda:Filarioidea) exhibits spontaneous rhythmical movements when suspended in isolated organ bath containing modified Ringer's solution. Pyrantel pamoate (50 ng/ml) when applied caused initial short lasting stimulation followed by irreversible paralysis. When suspended in calcium free bathing fluid the movements of n.m. preparation showed a gradual decrease both in amplitude and rate of contraction til the movements ceased completely. The effect was similar when EDTA was added to the bath fluid. The stimulant effect of Pyrantel pamoate was blocked in calcium free solution and in bath applied EDTA. Calcium channel blocker Nifedipine in a concentration of 500 ng/ml blocked the effect of Pyrantel pamoate (50 ng/ml). Neither stimulation nor depression of movements was evident with higher concentration of PP (250 mg/ml) the stimulant effect of Pyrantel pamoate was blocked while the depressant effect characterized by decrease in amplitude of calcium is essential for the stimulant effect of Pyrantel pamoate and its response on n.m. preparation is similar to Acetylcholine.
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PMID:Regulation of cholinomimetic action of pyrantel pamoate by calcium channels in Setaria cervi. 895 Jan 41

1. 3H-Noradrenaline (NA) and 14C-acetylcholine (ACh) released by electrical field stimulation were measured simultaneously in strips from the body of rat urinary bladder. 2. omega-Conotoxin GVIA (omega-CgTX; 20-100 nM) suppressed the non-facilitated transmitter release evoked by intermittent stimulation (IS), whereas nifedipine (1 microM) did not affect release. 3. Continuous electrical stimulation (CS) facilitated NA and ACh release via an atropine-sensitive mechanism. omega-CgTX reduced the facilitated release of NA (44% depression) but did not affect ACh release. Nifedipine depressed ACh release (43%) but not NA release. Combined administration of nifedipine and omega-CgTX (20 nM) produced a greater suppression of NA and ACh release (86 and 91%, respectively). 4. Maximal muscarinic facilitation of NA (5-fold) and ACh (17-fold) release occurred following administration of eserine, an anticholinesterase agent. Release of both NA and ACh was depressed by nifedipine (70 and 83%, respectively) but not by omega-CgTX. Combined application of omega-CgTX and nifedipine elicited a further depression of NA (95%) but not ACh release. 5. When NA and ACh release was facilitated with phorbol dibutyrate (0.5 microM), nifedipine inhibited ACh (67%) but not NA release, whereas omega-CgTX inhibited NA (73%) but not ACh release. Combined administration of both Ca2+ channel blockers did not elicit greater inhibition. 6. Bay K 8644, the L-type Ca2+ channel activator, increased ACh release in a dose-dependent manner (up to 5-fold) but did not significantly change NA release. 7. Both omega-CgTX (20-100 nM) and nifedipine (100 nM-1 microM) significantly decreased (50-80%) the neurally evoked contractions of the bladder strips. 8. It is concluded that L-type Ca2+ channels play a major role in muscarinic facilitation of NA and ACh release in the urinary bladder but are not essential for non-facilitated release. Other types of Ca2+ channels, including N-type, are involved to varying degrees in non-facilitated and facilitated release under different experimental conditions.
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PMID:Role of L- and N-type Ca2+ channels in muscarinic receptor-mediated facilitation of ACh and noradrenaline release in the rat urinary bladder. 913 Jan 61


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