The hypotensive action of calcium antagonist has been recognized, however, clinical study on the hypotensive effect is not yet extensively carried out. Auther studied the effect of Dilitiazem(Herben(R)) on 23 hypertensive patients. The age of patient was average 58.5(30-75) years. There were 8 male and 15 female patients. Among 23 cases, 20 cases of essential hypertension had no previous medication for hypertension and they were given 90mg of Diltiazem daily in 3 divied doses for 8 weeks. The blood pressure and pulse were measured at one week interval. In 3 cases of hypertension who were refractory to other hypotensive drugs for 2 weeks. The results were as follows; 1) In 20 cases of untreated essential hypertension, the control average blood pressure was 179.8/106.3mmHg and pulse 77.1/min. After the Diltiazem medication average blood pressure in one week was 153.3/97.3mmHg and pulse 76.6/min, in 3 week 153.0/94.0mmHg, and pulse 76.6/min, in 5 week 143.0/92.0mmHg and pulse 75.4/min, and in 8 week 142.3/90.0mmHg and pulse 73.0/min. These data showed that after one week of medication, blood pressure fell significantly in systole and diastole but there was no significant pulse change. 2) The rate of hypotensive effect by grade were as follows; overall effectiveness in systolic pressure which fell more than 5 mmHg was 85% and more than 20mmHg fall was 70%. In diastolic pressure the overall effectiveness which fell more than 5mmHg was 60% and more than 15 mmhg fall was 40%. 3) In 3 cases which were refractory to other hypotensive drugs, the hypertension became normal blood pressure in one day by 90mg Diltiazem and the fall of blood pressure persisted for 2 weeks by continuous medication.
Blood Pressure ; Calcium ; Diastole ; Diltiazem* ; Female ; Humans ; Hypertension* ; Male ; Systole

In this study, we evaluated systemic and pulmonary hemodynamic changes with the administration of diltiazem into pulmonary artery in hypoxia(F1O2 0.15)-induced pulmonary vasoconstriction in 7 mongrel dogs. Hypoxic gas induced pulmonary vasoconstriction(HPV) resulted in 23.8% increase of mean pulmonary arterial pressure(PAP) without any changes of pulmonary vascular resistance(PVR). A 200 ug/kg intravenous bolus of diltazem, followed by 10 ug/kg/min(DL)and 15 ug/kg/min(DH) for 20 min, respectively, produced no change in pulmonary arterial pressure. But this was accompanied by increase in PVR and PVR/SVR ration in DL and 20 min after DH. We conclude that diltiazem does not seem to decrease acute hypoxic pulmonary vasoconstrition in dogs and it might not be beneficial drug for this kind of pulmoary hypertension.
Animals ; Arterial Pressure ; Diltiazem* ; Dogs* ; Hemodynamics ; Hypertension ; Pulmonary Artery ; Vasoconstriction*

In this study, we evaluated systemic and pulmonary hemodynamic changes with the administration of diltiazem into pulmonary artery in hypoxia(F1O2 0.15)-induced pulmonary vasoconstriction in 7 mongrel dogs. Hypoxic gas induced pulmonary vasoconstriction(HPV) resulted in 23.8% increase of mean pulmonary arterial pressure(PAP) without any changes of pulmonary vascular resistance(PVR). A 200 ug/kg intravenous bolus of diltazem, followed by 10 ug/kg/min(DL)and 15 ug/kg/min(DH) for 20 min, respectively, produced no change in pulmonary arterial pressure. But this was accompanied by increase in PVR and PVR/SVR ration in DL and 20 min after DH. We conclude that diltiazem does not seem to decrease acute hypoxic pulmonary vasoconstrition in dogs and it might not be beneficial drug for this kind of pulmoary hypertension.
Animals ; Arterial Pressure ; Diltiazem* ; Dogs* ; Hemodynamics ; Hypertension ; Pulmonary Artery ; Vasoconstriction*

The antihypertensive effects of diltiazem was observed in 30 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral diltiazem was 42.0+/-2.5mmHg and 17.8+/-1.7mmHg. The results of antihypertensive therapy revealed good control in 50% fair control in 30% poor in 17% and failure in 3% of the cases. In 80% of the cases, good or fair control of Hypertension which means drop of diastolic pressure to the level of less than 100mmhg was observed. 2) Mean drop in heart rate was 21+/-2 beats/min. 3) Daily dose was 90-180mg. 4) The side effect of oral Diltiazem was mild headache and dizziness, respectively one case.
Blood Pressure ; Diltiazem* ; Dizziness ; Headache ; Heart Rate ; Hypertension

The effects of diltiazem and verapamil on the electrically-evoked twitch response, train-of- four and tetanic stimulation were studied in the isolated rat hemidiaphragm preparation. Diltiazem(3-150 pM) and verapamil(3-100 pM) increased the electrically-evoked(nerve stimulation, 0.1 Hz, 0.5 ms, 10 V) twitch responses in a dose-related fashion and diltiazem was more potent than verapamil. But, the large doses of diltiazem(150-300 uM) and verapamil(100-300 uM) decreased the twich responses. And the effects of diltiazem and verapamil were not effected by reducing the extracellular calcium from 2.5 to 1.25 mM. Diltiazem and verapamil decreased the train-of-four and tetanus ratio as well as the d-tubocurarine in a dose-related fashion. d-Tubocurarine, a specific nicotinic antagonist, decreased twitch response, and the potentiating twitch response of diltiazem was significantly inhibited by pretreatment of d-tubocura- rine. Furthermore, it is noteworth that the inhibitory effects of d-tubocurararine were markedly potentiated by diltiazem. In cases of the direct(muscle, 0.1 Hz, 5 ms, 10 V) stimulation, diltiazem and verapamil decreaaed the electrically-evoked twitch response with dose dependently. These results indicate that diltiazem and verapamil elicited two distinctive types of twitch response in the rat phrenic-hemidiaphragm preparation. The potentiating effect of twitch response is mediated by the acetylcholine release from the prejunctional nerve terminal and the inhibiting effect may be due to blcking influx of calcium and/or release of acetylcholine from presynaptic nerve terminals.
Acetylcholine ; Animals ; Calcium ; Diltiazem* ; Rats* ; Tetanus ; Tubocurarine ; Verapamil*

The hypotensive effect of diltiazem hydrochloride(Herben(R)) was investigated with 32 cases of essential hypertension. Diltiazem, 90-180mg per day, was administer ed in divided doses to each of the subjects for 6 week and the blood pressure lowering effect was assessed, as remarkably effective when the lowering of blood pressure was, 20mmHg or more of systolic pressure and 10mmHg or more of diastolic pressure; as satisfactorily effective when 20mmH or more of systolic pressure or 10mmHg or more of diastolic pressure was lowered; as fairly effective when 10-19mmHg of systolic pressure and 5-9mmHg of diastolic pressure. 1. With above mentioned criteria, diltiazem was remarkably, satisfactorily and fairly effective in 11(37%), 13(43%) and 1(3%) of 30 patients, respectively, while the drug was ineffective in 5(17%). 2. Diltiazem was effective in lowering of both systolic and diastolic blood pressure, and was effective as a sole agent of as an agent of combination therapy. 3. With diltiazem treatment, the depressed ST segment was conversed to isoelectric line in all of 10 cases which showed ST depression before diltiazem treatment and the elevated ST segment was conversed to isoelectric line in 1 of 2 cases. all of 4 cases with flat T wave and 10 of 12 cases with inverted T wave showed conversion to upright T waves after diltiazem treatment. 4. Undesirable side effects was observed in 2 cases out of 32 cases(6%); 1 case of erythema multiforme-like skin eruption and 1 case of the clinical aggravation of congestive heart failure, in whom the diltiazem administration was discontinued.
Blood Pressure ; Depression ; Diltiazem* ; Erythema ; Heart Failure ; Humans ; Hypertension* ; Skin

OBJECTIVE: To establish an high-performance liquid chromatography (HPLC) method for the determination of diltiazem hydrochloride injection. METHODS: The assay was conducted on a NUCLEODUR C18 column with buffer solution (pH6.2)-acetonitrile-methanol (40:30:30) as the mobile phase and the detection wavelength was 240 nm. RESULTS: Diltiazem hydrochloride and relevant substances could be separated under the condition. The linear concentration range of diltiazem hydrochloride was 4 - 200mg/L with the recovery of 100.22% (RSD = 0.37%). CONCLUSION The method may be used for the determination of diltiazem hydrochloride injection.
Calcium Channel Blockers ; analysis ; Chromatography, High Pressure Liquid ; Diltiazem ; analysis

BACKGROUND: Use of radial artery (RA) for coronary artery bypass grafting (CABG) is an increasingly common practice. The objective of our study was to compare the effects of two drugs as antispastic agents in patients undergoing CABG. METHODS: Sixty patients, submitting to CABG using the RA, were randomly assigned to two treatment groups (n = 30 in each group). Following the induction of anesthesia, the two groups were administered either 0.2-2microgram/kg/min nitroglycerin or 0.05-0.1 mg/kg/hr diltiazem as a continuous IV infusion. CABG in both groups was performed as per standard surgical protocol. RESULTS: The peak serum creatinine phosphokinase-MB level (59.3 ng/ml for nitroglycerin treatment versus 57.7 ng/ml for diltiazem treatment), postoperative ejection fraction (52.3% versus 48.4%), duration of stay in the ICU and total length of hospital stay were not significantly different between the groups (P > 0.05). However, the need for inotropic agents to prevent or treat intraoperative hypotension was less for patients in the nitroglycerin group than for patients in the diltiazem group (60.0% to 83.3%). CONCLUSIONS: Our results indicate that nitroglycerin is superior to diltiazem as an antispastic agent. We suggest that nitroglycerin should be the agent for choice for the prevention of conduit RA spasm.
Anesthesia ; Coronary Artery Bypass* ; Coronary Vessels* ; Creatinine ; Diltiazem ; Humans ; Hypotension ; Length of Stay ; Nitroglycerin ; Radial Artery ; Spasm*

We investigated whether symptom-free period(mean response time) could be prolonged when diltiazem, one of the calcium-channel blocker, as a adjuvant was administered with botulinum toxin in blepharospasm and hemifacial spasm. The patients were 10 blepharospasms and 20 hemifacial spasms who had been treating with botulinum toxin injection in our hospital. When they received only botulinum toxin for treatment of blepharospasm and hemifacial spasm, their mean response times were 126.94 +/- 42.74 and 167.32 +/- 52.90 days, respectively. After start combination therapy of diltiazembotulinum toxin, mean response times were prolonged to 163.83 +/- 53.07 (p=0.0446) in patients with blepharospasm, on the other hand, 154.21 +/- 43.36(p=0.2156) days in patients with hemifacial spasm. This study suggests that a combination treatment of diltiazem and toxin may be effective especially when the mean response time is decreased due to antibody production and the local complications are possibly expected in some patients. Present study is meaningful in that it provides a new treatment modality for blepharospasm and hemifacial spasm.
Antibody Formation ; Blepharospasm* ; Botulinum Toxins* ; Diltiazem* ; Hand ; Hemifacial Spasm* ; Humans ; Reaction Time

Concealed bypass tract (CBT) results from incomplete development of the atrioventricular (AV) annulus. CBT conducts only in a retrograde direction, and therefore does not cause pre-excitation on standard electrocardiograms. The most common tachycardia associated with CBT is an orthodromic atrioventricular reentrant tachycardia (AVRT): a pathway involving anterograde circuitry through the AV node and His Purkinje system and retrograde conduction over the accessory pathway. Orthodromic AVRT accounts for approximately 90%-95% cases of AVRT. Most incidences of CBT occur at the left free wall. Vagal maneuvers and/or intravenous (IV) adenosine are recommended for first line acute management of AVRT. However, pharmacological therapy with IV diltiazem, verapamil, or beta blockers can also be effective for acute treatment for orthodromic AVRT in patients who do not show pre-excitation on their resting ECG during sinus rhythm. The first-line ongoing therapy for AVRT is catheter ablation of CBT; when catheter ablation is not indicated or preferred, oral beta blockers, diltiazem, verapamil, flecainide, propafenone, or amiodarone are recommended.
Adenosine ; Amiodarone ; Atrioventricular Node ; Catheter Ablation ; Diltiazem ; Electrocardiography ; Flecainide ; Humans ; Incidence ; Propafenone ; Tachycardia ; Tachycardia, Supraventricular* ; Verapamil