New drug binding sites in Ca2+ channels

New classes of drugs modifying Ca2+ channel activity have become available, this may enlarge the clinical utilities that have been associated with established Ca2+ channel antagonists such as the dihydropyridines (for example, nifedipine). Two such classes are reviewed by Michael Spedding, Barry Kenny and Pierre Chatelain. Fantofarone is a non-dihydropyridine with a novel site of action in the L-type Ca2+ channel that appears to yield a distinct cardiovascular profile. In contrast, fluspirilene and related Na+ and Ca2+ channel inhibitors have a distinct site of action in Ca2+ channels, which is not specific for one channel type. The utility of Na+ and Ca2+ channel inhibitors in ischaemic stroke is compared with new and more selective Na+ channel inhibitors.