硝苯地平长期治疗停止后血管痉挛性心绞痛的反弹。
Rebound of vasospastic angina after cessation of long-term treatment with nifedipine.
作者信息
Lette J, Gagnon R M, Lemire J G, Morissette M
出版信息
Can Med Assoc J. 1984 May 1;130(9):1169-71, 1174.
The beneficial effect of calcium antagonists in the treatment of vasospastic angina is now well recognized. Although withdrawal symptoms have been reported following abrupt cessation of therapy with some cardiovascular drugs, there is no detailed report on similar complications of the cessation of therapy with calcium antagonists. In a 4-month period eight patients with well documented and well controlled vasospastic angina experienced a marked increase in the frequency and duration of anginal episodes at rest following the involuntary cessation of treatment with nifedipine, 10 to 20 mg four times a day. The increase began within 2 to 5 days after the cessation of treatment. Substitute therapy with isosorbide dinitrate, 30 mg, and verapamil, 80 to 120 mg, each four times a day, was effective in all cases. Although the mechanism responsible for this rebound phenomenon is not known, awareness of its existence is essential considering the widespread use of calcium antagonists.
钙拮抗剂在治疗血管痉挛性心绞痛方面的有益作用现已得到充分认可。虽然有报道称，突然停用某些心血管药物后会出现撤药症状，但关于停用钙拮抗剂治疗的类似并发症尚无详细报道。在4个月的时间里，8例记录良好且病情得到良好控制的血管痉挛性心绞痛患者，在非自愿停用硝苯地平（每日4次，每次10至20毫克）后，静息时心绞痛发作的频率和持续时间显著增加。这种增加在停药后2至5天内开始出现。用硝酸异山梨酯（每次30毫克）和维拉帕米（每次80至120毫克），均每日4次进行替代治疗，在所有病例中均有效。虽然导致这种反跳现象的机制尚不清楚，但考虑到钙拮抗剂的广泛使用，认识到其存在至关重要。
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