Calcium antagonists are now regarded as the most important advance in cardiac drug therapy since the advent of beta-adrenergic blocking agents. Acting baยญ sically as vasodilators-though with many other comยญ plex mechanisms especially in the case of the antiยญ arrhythmic calcium antagonists, these agents have grown in importance to become among the therapeutic agents of first choice for angina pectoris and hyperยญ tension. The major aim of the present book is to present the clinician with the information needed for the practical use of calcium antagonists. What do all the numerous and often conflicting trials say? Do these agents really work? If so, which agent and in what dose? How do the three front runners, verapamil, nifedipine and diltiaยญ zem compare in the efficacy and side-effects with each other? How do the new second generation agents, now entering the North American market, slot in and comยญ pare with the three first-liners? When the gloss is taken away from the advertisements, what is really left? The strong clinical bias of the present book should be complimented by further reading of books slanted towards fundamentals. One of the most important and recent of these is that by Dr Winifred Nayler (Calcium Antagonists, Academic Press, 1988). That book should be basic for essential background knowledge in the area of calcium antagonists. The important basic contribuยญ tions of Fleckenstein deserve emphasis
Basic Science: Channel-mediated calcium current in the heart. -- I -- Fundamental properties: Mechanisms, classification, sites of action. -- II -- Use and comparative properties of the three prototypical calcium antagonists in ischemic heart disease, including recommendations based on an analysis of 41 trials. -- III -- Use and comparative efficacy in hypertension and supraventricular arrhythmias. Minor indications. -- IV -- Side-effects and contraindications, drug interactions and combinations. -- V -- Second-generation agents. -- VI -- Clinical pharmacokinetics of first and second-generation agents. -- VII -- Summary Tables. -- VIII -- Epilogue. Where do we go from here?