The calcium channel blockers: pharmacology and clinical applications

The calcium channel blockers provide an exciting and effective new therapeutic tool in the management of ischaemic cardiac syndromes and may prove popular and effective in the treatment of a variety of other disorders. They have provided a new approach to treatment and have added new insights into the pathogenesis of ischaemic cardiac syndromes. Their introduction into clinical practice has been swift and many of our concepts regarding their pharmacologic activities in man remain based on theoretic considerations. Their expanding clinical use and further comparative studies will undoubtedly provide further information in regard to indications, adverse effects, drug interaction and long-term safety. Particular caution is advised when they are combined with certain antiarrhythmic agents, digitalis and particularly beta adrenergic blocking agents. Little is known about their interaction with various general anaesthetic agents and for this reason particular vigilance is required as more patients receiving these agents are admitted for surgical procedures.