Intestinal Infarction Due to Nifedipine Overdose

Abstract

The first case of intestinal infarction associated with nifedipine overdose is presented. This is also the first reported case of an overdose with an extended release nifedipine preparation. The formation of a large gastric concretion of nifedipine tablets may have enhanced its local vasodilatory effects thereby producing mesenteric hypoperfusion, ischemia, and infarction.     

硝苯啶对血浆血栓烷B_2与6-酮-前列腺素F_(1α)平衡作用的影响

22例冠心病患者(男18例,女4例;年龄65±5yr)用硝苯啶5mg,tid,po,4wk为一个疗程;服药前、后分别作血浆血栓烷B_2(TXB_2)、6-酮-前列腺素F_(1α)(6-K-PGF_(1α))和血清脂质测定。发现平均TXB_2浓度明显降低,6-K-PGF_(1α)浓度改变不明显,从而使6-K-PGF_(1α)/TXB_2比值明显增加(P<0.01);同时发现HDL-ch浓度升高,LDL-ch浓度下降,证明硝苯啶对冠心病防治有益。     

国产非洛地平对麻醉大鼠血流动力学的影响

研究国产非洛地平对麻醉大鼠血流动力学的影响，并与硝苯地平相比较，结果发现，国产非洛地平可使收缩压，舒张压和平均动脉压下降，其中ＤＢＰ下降最显著，降压时伴ｔ－ｄｐ／ｄｔ ｍａｘ明显缩短，而反映心肌收缩性能的ｄｐ／ｄｔ ｍａｘ，Ｖｐｍ和Ｖｍａｘ无明显改变；硝苯地平降压时，ｄｐ／ｄｔ，ｍａｘ，Ｖｐｍ和Ｖｍａｘ同时减少。     

硝苯地平缓释片与普通片治疗原发性高血压的疗效比较

目的：比较硝苯地平缓释片与普通片治疗原发性高血压的疗效。方法：用单盲、交叉对照法治疗４２例原发性高血压病人（男性２２例，女性２０例，年龄５４±ｓ７ａ）。甲组先用缓释片２０ｍｇ，ｐｏ，ｂｉｄ×１４ｄ，间隔１ｄ，改服普通片１０ｍｇ，ｐｏ，ｔｉｄ×１４ｄ，乙组服药先后次序与甲组相反，剂量相同，疗程均为２９ｄ。结果：缓释片与普通片的降压有效率分别为９８％及６４％，有明显差异（Ｐ＜０．０５），降压幅度缓释片也高于普通片（Ｐ＜０．０１），其影响病人心率加快反应显著小于普通片（Ｐ＜０．０１），其他不良反应的发生率较低，程度也较轻。结论：硝苯地平缓释片（２０ｍｇ，ｂｉｄ）较普通片（１０ｍｇ，ｔｉｄ）更高效而安全。     

硝苯地平与卡托普利单用及联合应用对低氧性肺动脉高压的作用

目的 :探讨硝苯地平与卡托普利单用及联用对低氧性肺动脉高压 (PAH)的作用。方法 :30例慢性阻塞性肺疾病 (COPD)合并肺心病病人 ,通过Swan_Ganz导管分别观察了硝苯地平 2 0mg舌下含服与卡托普利 2 0mg静脉注射 ,单用或 2药联用 3组各 10例对平均肺动脉压 (MPAP)等血流动力学参数的影响。结果 :硝苯地平无明显降低MPAP、肺血管阻力 (PVR)的作用 (P >0 .0 5) ,但却显著降低体循环平均压 (MAP )、动脉血氧分压Pao2 (P <0 .0 1,P <0 .0 5)。卡托普利可显著降低MPAP和PVR(P <0 .0 5) ,对MAP和Pao2 无明显的影响。 2药联用可更显著地降低MPAP、PVR (P <0 .0 1)。结论 :卡托普利是治疗低氧性PAH的一个有效药物 ,与硝苯地平联用有协同作用     

Effects of the calcium antagonist, isradipine, and nifedipine on resting and exercise haemodynamics and the neurohumoral system in patients with stable chronic angina

In a randomized double-blind study, the haemodynamic and anti-ischaemic effects of the new dihydropyridine calcium channel blocker isradipine (5 mg and 10 mg thrice daily (t.i.d.) were investigated over 1 week in nine patients with coronary artery disease and chronic effort angina and compared with nifedipine (20 mg t.i.d.) and placebo. In standardized exercise stress tests and exercise radionuclide ventriculography, haemodynamics improved under medication compared with placebo: resting end-diastolic and end-systolic volume index decreased on isradipine 5 mg, 10 mg and on nifedipine, and ejection fraction at rest increased with all medications. Resting mean arterial pressure was reduced compared with placebo accompanied by a decrease in systemic vascular resistance (P less than 0.05) and systolic wall tension (P less than 0.05). Cumulative ST-segment depression was significantly reduced by all three medications (-48%, -23%, -36%), while the increase in work capacity was insignificant. No significant change was found for either heart rate, double product, cardiac index, or stroke work index. Resting plasma levels of noradrenaline, adrenaline and renin activity increased with all three medications (except adrenaline at isradipine 5 mg). Isradipine has favourable effects comparable with those of nifedipine in patients with chronic stable angina and can be safely administered in these patients.     

DHEA和nifedipine对大鼠低氧性肺动脉高压的治疗作用比较

目的 对慢性缺氧3周大鼠静脉注射钾通道开放剂脱氢表雄甾酮(DHEA)和钙通道阻断剂nifedipine,以对照研究它们对大鼠慢性低氧性肺动脉高压的治疗作用。方法 60只大鼠随机分为2组,每组30只,均给予缺氧3周。Ⅰ组再分为3个小组(A1,A2,A3),分别按100mg/kg,150mg/kg和200mg/kg给予DHEA,Ⅱ组再分为3个小组(B1,B2,B3),按100mg,/kg,150mg/kg和200mg,/kg给予nifedipine。大鼠3周低氧后,行右心插管于给药前后分别测定2组大鼠的肺动脉平均压(mPAP)、体动脉平均压(mSAP)。结果 2组大鼠在缺氧3周后肺劝脉压均明显增高,Ⅰ组静脉给予DHEA可见A1,A2,A3组大鼠mPAP明显降低,呈剂量依赖性变化,但平均体动脉压变化不明显;Ⅱ组给予nifedipine后,可见B1,B2,B3组大鼠伴随mSAP明显降低,大鼠mPAP呈剂量依赖性降低。结论 钾通道活性的改变在HPH发病机制中起着十分重要的作用,钾通道开放剂DHEA可有效治疗HPH,且DHEA对体循环的影响相对较小。     

Clinical assessment of gingival hyperplasia in patients treated with nifedipine

Abstract Gingival hyperplasia caused by the use of nifedipine has been extensively reported. In this paper, the gingiva of 18 patients suffering from cardiopathy and treated with nifedipine were compared with those of 10 patients with cardiac disorders who had not been treated with calcium antagonists and with a no-treatment group of 12 patients. Nifedipine produced gingival hyperplasia although patients who had not been treated with calcium antagonists also had mild hyperplasia. Hyperplasia first appeared in the interproximal areas, an observation which may be important for early detection. There was a direct correlation between the degree of hyperplasia and the bacterial plaque score. When we studied the influence of administration time and dose of nifedipine with the degree of hyperplasia, no statistically significant differences were found.     

尼群地平(NT)和硝苯吡啶(NF)对离体豚鼠工作心脏的作用

连续记录的豚鼠离体工作心脏100min,50min内各项指标(AF、CF、LVP、dp/dtmax、ASP和HR等)值较稳定和可靠。其后有自然衰竭趋势,-dp/dtmax最先减慢,提示心脏的自然衰竭与心室舒张功能受损有关。0.1-100nMN T和0.001—10nM有负性肌力和降低心泵的作用,且呈剂量依赖关系。NT和NF抑制AF的ID_(50),分别为15.2nM和1.03nM;+dp/dtmax的ID_(50),分别为52.4nM和3.3nM;-dp/dtmax的ID_(50),分别为56.3nM和1.6nM,两者相差15倍以上,差异显著,提示NT对心脏的抑制作用比NF弱得多。