Scanu P, Commeau P, Huret B, Gérard J L, Debruyne D, Moore N, Lamy E, Dorey H, Grollier G, Potier J C
Service des soins intensifs cardiologiques, hôpital Côte de Nacre, CHU Caen.
Arch Mal Coeur Vaiss. 1987 Nov;80(12):1773-83.
Numerous studies have been devoted to the effect of slow calcium channel inhibitors on plasma digoxin concentrations. The principal drugs tested, verapamil and nifedipine, were found to increase significantly plasma digoxin levels mainly by reducing digoxin total clearance. Very few studies on the nicardipine-digoxin interaction have been reported. The dual purpose of the present study was to evaluate the influence of orally administered nicardipine on plasma digoxin concentrations over 24 hours and to measure possible variations in the pharmacodynamic effects of digoxin in 9 patients with chronic congestive heart failure. The pharmacodynamic assessment involved simple and cross-sectional echocardiography, systolic time interval measurements and cardiac catheterization. In these patients under chronic digoxin treatment, oral nicardipine had little effect on plasma digoxin concentrations which increased but not significantly; no sign of digitalis toxicity was observed. Nicardipine improved left ventricular function and myocardial contractility by reducing after-load, the nicardipine-induced peripheral vasodilatation tending to counteract the digoxin-induced vasoconstriction.
许多研究致力于探讨慢钙通道抑制剂对血浆地高辛浓度的影响。所测试的主要药物维拉帕米和硝苯地平，被发现主要通过降低地高辛的总清除率而显著提高血浆地高辛水平。关于尼卡地平与地高辛相互作用的研究报道极少。本研究的双重目的是评估口服尼卡地平对24小时内血浆地高辛浓度的影响，并测定9例慢性充血性心力衰竭患者地高辛药效学效应的可能变化。药效学评估包括简单和横断面超声心动图、收缩期时间间期测量以及心导管检查。在这些接受慢性地高辛治疗的患者中，口服尼卡地平对血浆地高辛浓度影响不大，虽有升高但不显著；未观察到洋地黄中毒迹象。尼卡地平通过降低后负荷改善了左心室功能和心肌收缩力，尼卡地平引起的外周血管扩张倾向于抵消地高辛引起的血管收缩。
