Calcium channel blocker [Neurosurgery Wiki]

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====== Calcium channel blocker ======

[[Amlodipine]]

[[Nifedipine]]

===== Calcium channel blocker neurosurgery Latest Pubmed Related Articles=====

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1nI_xFaT3LgvxDo3usexstwZ9LqafVsX0tIClJVI1EioeJ8QmJ/?limit=15&utm_campaign=pubmed-2&fc=20230509052432}}
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[[Calcium channel]] blockers (CCB), calcium channel antagonists or calcium antagonists are several medications that disrupt the movement of calcium (Ca2+
) through calcium channels.

Calcium channel blockers are used as antihypertensive drugs, i.e., as medications to decrease blood pressure in patients with hypertension. CCBs are particularly effective against large vessel stiffness, one of the common causes of elevated systolic blood pressure in elderly patients.

Calcium channel blockers are also frequently used to alter heart rate, to prevent cerebral vasospasm, and to reduce chest pain caused by angina pectoris.

N-type, L-type, and T-type voltage-dependent calcium channels are present in the zona glomerulosa of the human adrenal, and CCBs can directly influence the biosynthesis of aldosterone in adrenocortical cells, with consequent impact on the clinical treatment of hypertension with these agents.

CCBs have been shown to be slightly more effective than beta blockers at lowering cardiovascular mortality, but they are associated with more side effects.

Potential major risks however were mainly found to be associated with short-acting CCBs.

see [[Nicardipine]].
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Analysis suggests that several types of [[statin]]s, [[calcium channel blocker]]s, and [[angiotensin II receptor blocker]]s are candidate drugs for the preventive treatment of [[unruptured intracranial aneurysm]]s
((Shimizu K, Imamura H, Tani S, Adachi H, Sakai C, Ishii A, Kataoka H, Miyamoto S, Aoki T, Sakai N. Candidate drugs for preventive treatment of unruptured intracranial aneurysms: A cross-sectional study. PLoS One. 2021 Feb 12;16(2):e0246865. doi: 10.1371/journal.pone.0246865. PMID: 33577580.)).
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Al-Mufti et al. from the [[Rutgers New Jersey Medical School]], describe a case of medically refractory [[Reversible cerebral vasoconstriction syndrome]] (RCVS) that required treatment with intra-arterial (IA) [[verapamil]] and subsequent [[nimodipine]], resulting in both angiographic and clinical improvement after failing to respond to [[hemodynamic]] augmentation. 

They also supplement a description of the case with a [[review]] of other case studies and case series in which IA [[calcium channel blocker]]s were used to treat RCVS. They propose that the case they outline demonstrates that neurointerventional management with IA verapamil is appropriate and effective as an early intervention of medically refractory RCVS.

Using [[PubMed]] and [[Google Scholar]], they performed a search of the English language [[literature]] with several combinations of the keywords "intra-arterial", "calcium channel blockers", "reversible cerebral vasoconstriction syndrome", "RCVS", "nimodipine", "verapamil", "milrinone", and "nicardipine" to identify studies in which RCVS was treated with IA calcium channel blockers.

They identified eight case studies and case series that met our inclusion criteria. Eighteen patients are encompassed in these eight studies.

IA administration of [[calcium channel blocker]]s has been shown to return cerebral vessels to their normal caliber in patients with medically refractory RCVS. However, there are no [[randomized controlled trial]]s of the treatment of RCVS, and further studies are needed to elucidate the optimal treatment protocol for medically refractory RCVS
((Al-Mufti F, Dodson V, Wajswol E, El-Ghanem M, Alchaki A, Nuoman R, Thabet A,
Sutherland A, Roychowdhury S, Hidalgo A, Gupta G. Chemical angioplasty for
medically refractory reversible cerebral vasoconstriction syndrome(). Br J
Neurosurg. 2018 Sep 12:1-5. doi: 10.1080/02688697.2018.1479512. [Epub ahead of
print] PubMed PMID: 30207193.
)).

===== Intra-arterial Infusion of Calcium Channel Blocker =====

[[Intra-arterial Infusion of Calcium Channel Blocker]].