Larach D R, Zelis R
Am J Surg. 1986 Apr;151(4):527-37. doi: 10.1016/0002-9610(86)90119-4.
Calcium blockers are drugs that interfere with the entry of calcium ions into cells of a variety of tissues. Three calcium blockers, verapamil, nifedipine, and diltiazem, are currently approved for clinical use in the United States and many others are undergoing clinical trials. All calcium blockers share the effect of dilating blood vessels, although some agents are selective dilators of certain vascular beds, such as the coronary or cerebral circulation. There exist major differences among these drugs in their ability to depress myocardial contraction and inhibit cardiac impulse conduction, as well as other properties. The therapeutic actions of the agents in use, as well as the actions of the investigational calcium blockers, have been reviewed. Although calcium blockers are generally well tolerated and have fewer side effects than many alternative drugs, serious adverse effects are possible in certain clinical settings. The clinical indications for these drugs continue to expand and will likely find many uses in surgical patients, especially in the areas of cardiac surgery, neurosurgery, vascular surgery, and general surgery.
钙通道阻滞剂是一类能干扰钙离子进入多种组织细胞的药物。目前，维拉帕米、硝苯地平和地尔硫䓬这三种钙通道阻滞剂已在美国获批用于临床，还有许多其他药物正在进行临床试验。所有钙通道阻滞剂都有扩张血管的作用，不过有些药物是某些血管床（如冠状动脉或脑循环）的选择性扩张剂。这些药物在抑制心肌收缩、抑制心脏冲动传导以及其他特性方面存在重大差异。已对现有药物的治疗作用以及正在研究的钙通道阻滞剂的作用进行了综述。尽管钙通道阻滞剂通常耐受性良好，且副作用比许多其他替代药物少，但在某些临床情况下仍可能出现严重不良反应。这些药物的临床适应证不断扩大，可能会在外科手术患者中得到广泛应用，尤其是在心脏手术、神经外科手术、血管外科手术和普通外科手术领域。
