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PubMed · 4066622

A possible interaction between lithium and diltiazem: case report.

E V Valdiserri
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Abstract

The calcium channel blockers are a group of drugs that have recently become available for the treatment of angina. They act by blocking the entry of calcium into cells during depolarization. Lithium has electrochemical qualities similar to calcium and influences calcium metabolism and calcium transport. The case reported here documents the use of diltiazem in a patient treated with lithium. A possible synergistic drug interaction occurring between diltiazem and lithium is reported.

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Angina PectorisBenzazepinesBipolar DisorderCalciumDiltiazemDrug SynergismDrug Therapy, CombinationHumansLithiumMaleMiddle AgedParkinson Disease, SecondaryCase ReportsJournal Article

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BibTeXRIS

E V Valdiserri. 1985. A possible interaction between lithium and diltiazem: case report.. https://pubmed.ncbi.nlm.nih.gov/4066622/

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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