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Diltiazem: possible hematologic complications
Insights
Calcium channel blockers may impair platelet function, increasing bleeding risks. Discontinuation of diltiazem normalized bleeding times in three patients, highlighting potential surgical complications.
Area of Science:
- Pharmacology
- Neurology
- Hematology
Background:
- Calcium channel blockers are explored for cerebral vasospasm prevention and treatment.
- In vitro and in vivo studies suggest these drugs inhibit platelet function.
- Clinical data on abnormal platelet function due to calcium blockers is limited.
Abstract:
Calcium blockers are being investigated for a potential role in the prevention and treatment of cerebral vasospasm. They have been found to inhibit platelet function both with in vivo and with in vitro experiments. Clinical evidence of abnormal platelet function is sparse, however. We are presenting three patients who developed increased bleeding times that reverted to normal when the diltiazem was discontinued. This may lead to serious consequences in the presence of an unsecured aneurysm and for patients facing major intracranial surgery.