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Stereoselectivity in cardiovascular and biochemical action of calcium antagonists: Studies with the enantiomers of the dihydropyridine nitrendipine
Author(s) -
Mikus Gerd,
Mast Vivian,
Ratge Dieter,
Wisser Hermann,
Eichelbaum Michel
Publication year - 1995
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/0009-9236(95)90265-1
Subject(s) - nitrendipine , blood pressure , heart rate , plasma renin activity , medicine , vascular resistance , endocrinology , hemodynamics , chemistry , norepinephrine , dihydropyridine , aldosterone , pharmacology , calcium , renin–angiotensin system , dopamine
Objectives The cardiovascular and biochemical effects of R ‐ and S ‐nitrendipine were studied in six healthy subjects in a single‐blind placebo‐controlled study. Methods After received oral doses of placebo, 20 mg R ‐, 80 mg R ‐ ( n = 5), 20 mg S ‐, and 20 mg racemic nitrendipine, heart rate, systolic, diastolic, and mean arterial blood pressure, leg blood flow, peripheral vascular resistance, plasma renin activity, norepinephrine, epinephrine, dopamine, and aldosterone plasma levels were measured before and up to 3 hours after administration. Results Neither placebo nor 20 or 80 mg R ‐nitrendipine caused significant changes of cardiovascular and biochemical parameters. After 20 mg S ‐nitrendipine and 20 mg racemic nitrendipine, significant changes in diastolic blood pressure (−9.1/−7.4 mm Hg), heart rate (+21.9/+17.3 beats/min), leg blood flow (+6.8 ml · min −1 · gm tissue −1 ), peripheral vascular resistance (−16.9 mm Hg · min · gm tissue · ml −1 ), norepinephrine (+476/+281 ng · L −1 ), and plasma renin activity (+9.5/+3.6 ng · ml −1 · hr −1 ) were observed. The changes in cardiovascular and biochemical parameters were closely related to the serum S ‐nitrendipine concentrations. Conclusions It can be concluded that, after administration of the racemate, the S ‐enantiomer is responsible for the cardiovascular and biochemical effects observed and that S ‐nitrendipine is at least an order of magnitude more potent than the R ‐enantiomer. Clinical Pharmacology & Therapeutics (1995) 57 , 52–61; doi: