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雷诺嗪:抗慢性心绞痛药物新成员 总被引:2,自引:0,他引:2
雷诺嗪是哌嗪类衍生物,多个临床试验证实其有确切的抗心绞痛作用和良好的耐受性及安全性,而对血流动力学无影响,2006年已被批准与其它抗心绞痛药物联合治疗慢性心绞痛,其作用机制可能与部分抑制脂肪酸氧化、抑制晚钠电流从而减轻细胞内钙超载有关。现综述了雷诺嗪的药代动力学特征、可能的作用机制及治疗心绞痛的相关临床试验。 相似文献
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目的 研究雷诺嗪对大鼠肝重、肝微粒体蛋白质及细胞色素P450含量的影响.方法 将大鼠分成空白对照组和雷诺嗪组各8只,雷诺嗪组连续给予雷诺嗪为50 mg·kg-1·d-1,连续灌胃给药7 d后,测定大鼠的肝重、肝微粒体蛋白质及细胞色素P450含量,氨基比林-N-脱甲基酶、红霉素脱甲基转移酶和7-乙氧基-3-异吩噁唑酮脱烃酶的活性.结果 雷诺嗪灌胃7 d后,大鼠肝重、肝微粒体蛋白含量与对照组比较差异无显著性;雷诺嗪组肝微粒体细胞色素P450含量与对照组比较明显减少(P<0.01).雷诺嗪对大鼠肝微粒体中红霉素脱甲基酶和7-乙氧基-3-异吩噁唑酮脱烃酶的活性基本无影响,对氨基比林-N-脱甲基酶有明显的抑制作用(P<0.05).结论 雷诺嗪可能引起肝药酶对某些药物代谢的改变. 相似文献
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雷诺嗪是一个新型的心血管治疗药物,其作用机制同其抑制心肌细胞动作电位中的晚期钠离子流有关。雷诺嗪能有效抑制晚钠内流,进而缓解心肌缺血,改善心脏舒缩功能和遏止相关心律失常的发生,临床研究表明雷诺嗪可提高运动耐量,减少心绞痛发作次数,减少硝酸甘油用量。雷诺嗪尚有抗心律失常和改善心脏收缩及舒张功能的作用。 相似文献
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目的:考察反复给予雷诺嗪{N-(2,6二甲基苯基)-2-4-[2-羟基-3-(2-甲氧苯氧基)丙基]-1-哌嗪乙酰胺}对大鼠产生的毒性反应。方法:SD大鼠随机分为雷诺嗪高、中、低剂量(400,150和50 mg.kg-1.d-1)组和溶媒对照(0.5%羧甲基纤维素钠)组,每组32只大鼠,雌雄各半。各组均灌胃给予等体积的药物或溶媒(20 mL.kg-1),每周给药7 d,连续给药4周。停药后每组留12只动物(雌雄各半)再饲喂2周进行恢复性观察。观察动物一般状况、体重、进食量、饮水量、血液学、血液生化学、脏器重量系数及组织病理学改变。结果:雷诺嗪400 mg.kg-1组大鼠给药初期出现活动减少、呆滞和抽搐,体重增加值低于对照组,饮水量、丙氨酸氨基转换酶(ALT)、尿素氮(BUN)、总胆固醇(T-Cho)及肝、肾系数高于对照组。雷诺嗪50和150 mg.kg-1组各项指标与对照组比较均无统计学差异。恢复期各剂量的各项指标与对照组比较均无统计学差异。结论:雷诺嗪150 mg.kg-1为安全剂量,400 mg.kg-1有短时神经系统毒性并对动物生长,肝、肾功能和脂代谢产生可逆性影响。 相似文献
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Basmah Safdar Gail D’Onofrio James Dziura Raymond R. Russell Caitlin Johnson Albert J. Sinusas 《Clinical therapeutics》2017,39(1):55-63
Purpose
Coronary microvascular dysfunction (CMD) is a common but underdiagnosed cause of chest pain. Literature is scant regarding effective treatments. We explored the effect of ranolazine on coronary flow reserve (CFR) among symptomatic patients with CMD.Methods
This pilot double-blinded randomized controlled trial included emergency department patients with chest pain and CMD admitted to an observation unit between June 2014 and November 2015. Participants were assessed by cardiac Rb-82 positron emission tomography and computed tomography imaging at baseline and 30 days. CMD was defined as CFR <2 corrected for rate pressure product or <2.5 uncorrected, with no evidence of obstructive or nonobstructive coronary artery disease or calcification. Patients with infarction, hypertensive urgency, heart failure, or prescribed QTc-prolonging drugs were excluded. Participants were assigned to ranolazine or placebo in a 2:1 ratio. Primary outcome was change in CFR at 30 days.Findings
We enrolled 31 patients (71% female, mean [SD] age 50 [6] years) with CMD (mean [SD] corrected CFR 1.6 [0.3]). Ranolazine improved CFR at 30 days by 17% (P = 0.005) compared with 0% with placebo (P = 0.67). However, there was no significant difference in the primary outcome as measured by mean change in CFR (0.27 ranolazine compared with 0.06 placebo; 95% CI, ?0.08 to 0.62).Implications
The emergency department offers a unique venue to diagnose CMD with acute symptoms. In an exploratory randomized controlled trial of symptomatic patients with CMD and no coronary artery disease, promising results were seem with ranolazine and CFR improving at 30 days. Large robust clinical trials are needed to verify improvement of CMD in a sex-specific model. ClinicalTrials.gov identifier NCT02052011. 相似文献8.
目的建立HPLC-MS/MS法测定人血浆中雷喏嗪的质量浓度。方法以伏立康唑为内标,采用乙腈-体积分数0.1%甲酸水溶液(90∶10)为流动相,以Agilent-ZORBAX-C18柱(150 mm×2.1 mm,5.0μm)色谱柱为分析柱,通过电喷雾离子源(ESI),以正离子多反应监测(MRM)方式进行检测。雷喏嗪和伏立康唑用于定量分析的离子对分别为[M+H]+m/z428.5→m/z279.3和[M+H]+m/z350.2→m/z281.3。结果雷喏嗪线性范围为20~5 000 ng·mL-1,定量下限为20 ng·mL-1。日内和日间的RSD均小于15%,平均回收率大于75%。结论该方法专属性强,样品处理方便,灵敏度高,适用于雷喏嗪的临床药动学研究。 相似文献
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目的 研究雷诺嗪对兔心室肌细胞快钠电流的影响.方法 运用全细胞膜片钳记录方法了解雷诺嗪对兔心室肌细胞快钠电流的作用,并了解其是否存在使用依赖性阻滞作用.结果 30μmol/L雷诺嗪对兔心室肌细胞快钠电流有明显的抑制作用,其IC50为(39.3±2.0)μmol/L,并且随着刺激频率的增加其作用加强,存在使用依赖性.结论 雷诺嗪对兔心室肌细胞快钠电流有一定的抑制作用,其存在使用依赖性阻滞作用. 相似文献
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Effects of Ranolazine on Ischemic Threshold, Coronary Sinus Blood Flow, and Myocardial Metabolism in Coronary Artery Disease 总被引:1,自引:0,他引:1
Jens Peder Bagger Hans Erik Bøtker Anne Thomassen Torsten Toftegaard Nielsen 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》1997,11(3):479-484
Cytoprotection or metabolic modulation is a new principle in the treatment of angina pectoris. The effect of ranolazine (a cytoprotective drug) on ischemic threshold, coronary sinus blood flow, and myocardial metabolism was evaluated by means of two pacing sequences in nine male patients with coronary artery disease (CAD) and in eight male controls. Ranolazine was given as an intravenous bolus followed by continuous infusion; the mean total dose was 32.7 mg and 31.7 mg in patients and controls, respectively. Angina pectoris was relieved in two patients after ranolazine but pacing time to pain was unchanged in the remaining patients. Maximal ST depression was lower (p = 0.02), but pacing time to maximal and to 1-mm ST depression remained unchanged after the drug. Ranolazine had no overall influence on coronary sinus blood flow, cardiac oxygen consumption, blood pressure, and heart rate. Cardiac uptake of free fatty acids (FFA) was reduced (p = 0.01), and net uptakes of glucose (p = 0.07) and lactate (p = 0.06) tended to be lower after ranolazine in CAD patients and controls. Ranolazine had no direct influence on cardiac exchange of glutamate, alanine, and citrate or on the arterial concentration of any metabolite. In the present study ranolazine had minimal clinical effects. A decrease in myocardial FFA utilization, however, allows greater myocardial glucose oxidation, which may increase the energy production in relation to oxygen availability. 相似文献