Akintonwa D A, Odigwe C O
Center for Theoretical Mechanistic Biochemistry, Calabar. Cross Over State, Nigeria.
Med Hypotheses. 2000 Jun;54(6):944-7. doi: 10.1054/mehy.1999.0990.
Theoretical mechanistic biochemistry (TMB) analysis was used to predict the therapeutic effects of calcium channel blockers in the drug management of hypertension, cerebrovascular disorders (CVD) and coronary artery disease (CAD). This analysis was extended to acetylsalicylic acid (aspirin) a non-calcium channel blocker which is nevertheless commonly used in the management of the same disorders. TMB data have suggested nisoldipine, nicardipine and nimodipine as agents of choice in the management of cerebrovascular disease, e.g. in transient ischemic attacks (TIAs). The same agents were found preferable in the management of coronary artery disease. It is noteworthy that atherosclerosis and vascular spasm are common pathogenic events in both conditions. For lowering blood pressure, without compromising cerebral and coronary blood flows TMB data suggested nisoldipine, nicardipine, nimodipine and nifedipine in that preferential order. For tissue selectivity, TMB data have identified nisoldipine, nicardipine, nifedipine, nimodipine and nitrendipine for vascular tissue and that verapamil, diltiazem and aspirin have little or no tissue selectivity. TMB data have gone further to suggest a combination of nicardipine, nisoldipine or nimodipine with beta-blockers in order to reduce the frequently uncomfortable reflex tachycardia often induced by some calcium channel blockers. By and large, TMB predicted data have been found to correlate reasonably well with clinically observed and reported therapeutic effects of calcium channel blockers. Their consistency in the management of hypertension, cerebrovascular disease and coronary artery disease is apparent in this study.
理论机制生物化学（TMB）分析被用于预测钙通道阻滞剂在高血压、脑血管疾病（CVD）和冠状动脉疾病（CAD）药物治疗中的疗效。该分析扩展至乙酰水杨酸（阿司匹林），它虽不是钙通道阻滞剂，但常用于相同疾病的治疗。TMB数据表明，尼索地平、尼卡地平和尼莫地平是脑血管疾病治疗的首选药物，如短暂性脑缺血发作（TIA）。在冠状动脉疾病的治疗中，同样发现这些药物更可取。值得注意的是，动脉粥样硬化和血管痉挛是这两种疾病常见的致病因素。为了降低血压且不影响脑和冠状动脉血流，TMB数据按优先顺序推荐了尼索地平、尼卡地平、尼莫地平和硝苯地平。就组织选择性而言，TMB数据确定了尼索地平、尼卡地平、硝苯地平、尼莫地平和尼群地平对血管组织有选择性，而维拉帕米、地尔硫䓬和阿司匹林几乎没有组织选择性。TMB数据进一步表明，将尼卡地平、尼索地平或尼莫地平与β受体阻滞剂联合使用，以减少一些钙通道阻滞剂常引起的令人不适的反射性心动过速。总体而言，已发现TMB预测数据与钙通道阻滞剂临床观察和报道的疗效有合理的相关性。在本研究中，它们在高血压、脑血管疾病和冠状动脉疾病治疗中的一致性显而易见。
