Cardizem (Diltiazem) is a drug from the group of slow calcium channel blockers and is a benzodiazepine derivative. Available in the form of tablets or capsules, with a dosage of 60, 120, and 180 mg. It has several pharmacological actions on the human body, including antianginal - against pain in the heart, hypotensive - lowering the pressure of a person, and antiarrhythmic - eliminate abnormalities on the ECG, such as supraventricular tachycardia, atrial flutter, etc. Another name of Cardizem is Diltiazem and it is a prescription drug.
The mechanism of antianginal action is associated with an improvement in the blood supply to the myocardium due to a decrease in the total peripheral vascular resistance, afterload on the heart, as well as an increase in the relaxation time of the heart - diastole. The antiarrhythmic effect is associated with the suppression of the transport of calcium ions in the heart and an increase in the refractory period. A decrease in pressure occurs due to vasodilation and a decrease in peripheral resistance. In addition, the drug reduces the heart rate, reduces myocardial contractility, lowers the tone of the arteries and reduces the oxygen demand of the heart.
Adsorption occurs in the gastrointestinal tract. The drug is metabolized in the liver. After the first passage through the liver, the entire dose of the drug is converted into an active substance, but the bioavailability is 40%. The half-life is 3-5 hours. It is excreted in bile and urine in the form of metabolites, only a small part up to 4% remains unchanged. Hemodialysis is not significant in the pharmacinetics of the drug.
The drug is suitable for men and women, including the elderly patients.
Capsules and tablets must be taken before meals and washed down with a little water without crushing.
It is forbidden to use the drug with an expired shelf life.
The initial dosage of the drug Cardizem is 90 mg 2 times a day, the maximum allowable dose is 360 mg per day. The drug can be used in 3 doses of 60 mg.
There are prolonged-release forms and their frequency of administration is less.
In case of an overdose of the drug diltiazem, in-line effects of the drug are observed, however, they are much more pronounced. These include: decreased heart rate, pressure drop, blockade and heart failure.
Enflurane is a conduction disorder.
Cimetidine - enhancing the effects by increasing the concentration of the drug.
Rifampicin - promotes faster excretion.
Nifedipine is an enhanced antihypertensive effect.
Sodium nitroprusside - arterial hypertension is more easily controlled.
Amidotrizoad - increased antihypertensive effect.
Lithium carbonate - psychosis, acute parkinson's syndrome.
Amiodarone - increased bradycardia, impaired conduction, AV block.
Atenolol, metoprolol, propranolol - cardiodepressive activity.
Cyclosporine - increases the concentration in blood plasma, but decreases nephrotoxicity and enhances the immunosuppressive effect.
Theophylline - decreased metabolism.
Midazolam, Triazolam - increased concentration, increased effects.
Carbamazepine, Phenytoin - increases concentration, toxic effect.
Imipramine - increases concentration, changes in ECG.
Insulin - Reducing Effects.
Digoxin - increases concentration.
Busipiron - concentration increases, therapeutic and side effects increase.
Statins - increases concentration. There are cases of rhabdomyolysis.
Propranolol, metoprolol - reduces metabolism.
Monitor blood pressure, electrocardiogram and heart rate during dose selection. Especially if additional drugs are used that affect the function of the heart. Particular attention should be paid to the selection of doses in patients prone to bradycardia and hypotension.
Drinking alcohol during treatment is prohibited.
The drug should be withdrawn gradually. When using prolonged forms, it is undesirable to use drugs from the group of B-blockers.
The drug can affect the emotional background of a person, reduce mood and even cause depression. In such cases, it is recommended to cancel the drug intake.
Be sure to inform the medical staff about taking diltiazem.
In the event of dermatological side effects, they can be variable and disappear with prolonged use of diltiazem.
Use in patients with impaired renal function, as well as in elderly patients If in patients of this group there is an increase in the concentration of diltiazem, then the use of lower doses is recommended.
For patients with diabetes mellitus, an adjustment of the doses of antidiabetic drugs is required.
No features of the influence of Cardizem on the ability to drive a vehicle or potentially dangerous mechanisms were noticed.
The drug Cardizem (Diltiazem) is teratogenic passes into breast milk. Forbidden to use during pregnancy and lactaion.
Variant, vasospastic or Pritsmetal - all these are the names of one angina pectoris, which is quite rare in comparison with the other diseases and characterized by chest discomfort or pain at rest. In fact, everything is simple - Pritzmetall's angina is named after the doctor who first described it in 1958. The name vasospastic indicates a connection with vascular spasm. Angina pectoris is associated with a sharp stenosis of the coronary artery and if angiography is performed, the vessel will be clean and without plaques that close the lumen. There are exceptions and the effect of two factors at once occurs: plaques and a dynamic factor. According to statistics, men get sick 5 times more often than women.
The main distinguishing cause of this angina pectoris is pain in the heart, which occurs acutely. Also, this pain is not associated with physical activity and usually occurs in the morning. This does not exclude the appearance of pain at any other time. It is especially important to note that taking classical nitroglycerin will be ineffective in this case, which is one of the important criteria for differential diagnosis. Calcium channel blockers are especially effective in relieving pain.
One of the frequent concomitant signs of vasospastic angina is severe pain in the head - migraine. This symptom occurs in 25% of cases. The same statistics and with Raynaud's syndrome and aspirin asthma. Raynaud's syndrome manifests itself as redness of the hands, especially in the cold, and this is due to a sharp vasoconstriction. Aspirin asthma is shortness of breath, shortness of breath associated with the intake of acetylsalicylic acid.
This is a sharp pain in the chest that appeared between 12 am and early morning. In practice, it is more often in the morning. Headaches and fainting can also be a signal. Wave-like attacks are possible, alternating with improvement. On the ECG - the ST segment rises, for a certain time, but not more than 30 minutes. The appearance of ventricular arrhythmia and AV block.
In order to recognize Pritzmetall's angina pectoris, a specialist is needed. It is especially difficult to differentiate it from rest angina. Clinically, they are very similar, but more often with vasospastic angina there are no atherosclerotic plaques on the coronary vessels. Only excluding unstable and stable angina is it possible to diagnose variant angina.
If at the time of an attack it is possible to register an ECG at the peak of an anginal attack, then a horizontal rise above the isoline of the S-T segment will appear, which is also typical for the stages of myocardial infarction. Pritzmetal's angina lasts a few seconds or minutes, after which it quickly returns to normal.
The most provoking factor is considered to be smoking. About 50% of experienced smokers have this pathology. And besides this, they experience concomitant diseases that aggravate the situation, for example: arterial hypertension, diabetes mellitus, obesity, cholecystitis, peptic ulcer, and so on.
Mortality in patients with vasospastic angina pectoris during the year is 5%, and within 5 years it rises to 11%. The prognosis worsens even more if there are aortosclerotic plaques in the arteries.
If the diagnosis is timely, remission occurs in half of the patients, which makes it possible to reduce the dosage of the drugs used.
As a treatment for alternative medicine, herbal decoctions and preparations are used, which have a cardiotonic and anticoagulant effect to improve blood circulation and blood clotting. The group of such herbs includes: hawthorn, motherwort, dill, rose hips, asparagus, chicory and others. In addition to herbs, moderate exercise also has beneficial effects as a preventive measure.
This can also include breathing exercises. Respiratory gymnastics, exercises on a breathing simulator help to improve blood circulation. That is why this exercise is considered one of the best in the prevention and support of various types of angina pectoris.
First of all, this improves microcirculation due to vasodilation, as a result of which the supply of oxygen to cells, as well as to the myocardium, increases. This helps to reduce the frequency of angina attacks.
It is worth refusing to exercise if you feel unwell, your blood pressure has increased, or an exacerbation of any chronic existing diseases has occurred. If you feel better after some time, it is recommended to resume the exercise.
Angina is a very insidious disease. Therefore, even if you feel well and are just being treated at home, do not forget about qualified help. Only a qualified specialist can help you choose the right treatment and track your heart condition.
You must understand that traditional medicine does not always work and most often it can only be attributed to prevention. Traditional medicine can never replace medication.
The disease is dangerous due to oxygen starving myocardial cells due to insufficient blood flow. This leads to serious consequences, up to the development of myocardial infarction.