Diltiazemum

Diltiazemum est calcii canalium inhibitor et medicamentum pharmaceuticum ad hypertoniam et anginam pectoris tractandam.

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**Diltiazemum**
Natura chemica


Formula chemica	C₂₂H₂₆N₂O₄S
Massa molaris	414.519 g/mol
PubChem	39186
DrugBank	DB00343
Natura pharmacologica
Codex ATC	C05AE03 (WHO) C08DB01 (WHO)
Tempus semivitae biologicum	3-4.5 h
Metabolismus	iecore (hepaticus): CYP3A4
Excretio	renibus, faeces, lacte
Ad usum therapeuticum
Applicatio	per os
MedlinePlus	a684027 (Anglice)

Natura Diltiazemi

Natura chemica

Nomen IUPAC Diltiazemi est cis-(+)-5-(2-dimethylaminoethylo)-2-(4-methoxy-phenyl)-4-oxo-2,3,4,5-tetrahydro-1,5-benzothiazepin-3-ylacetatum.

Benzothiazepinum

Diltiazemum est substantia chemica benzothiazepinorum. Benzothiazepinum heterocyclus fusio chemica ex benzeno et 1,4-thiazepino (heterocyclus cum quinque atomis carbonii et singulari nitrogenii) et singulari sulphuri) est.

Natura pharmacologica

Diltiazemum est medicamentum cum virtutibus antihypertensivis. Caudices ATC sunt C03AE03 (WHO) et C08DB01 (WHO).

Pharmacodynamica

Pharmacocinetica

Diltiazemum est substratum cytochromatis CYP3A4. Tempus semivitae biologicum $t_{\frac {1}{2}}$ .^[1] circa 3-4.5 h est. Excretio est per urinas et per faeces.

Effectus Diltiazemi

Diltiazemum effectuus antihypertensivorum suorum vasodilatationem et relaxationem musculorum levium perficit. Praeterea nodus atrioventricularis cordis deprimitur. Exempli effectuum non desideratorum posse sint: vomitus, diarrhoea, bradycardia (pulsus tardus), insufficientia cordis, reactio allergica.^[2]

Interactiones

Periculose sit consumptio Diltiazemi cum beta receptoria inhibitoribus^[3] sive Chinidino (substantia antiarrhythmica). Diltiazemum interagere quoque possit per exemplum (!) cum Ciprofloxacino (incrementum Diltiazemi per CYP3A4 tardum); anticonvulsivae substantiae diminutionem effectuum Diltiazemi perficere possunt.

Etiam Diltiazemum inhibitor CYP3A4 moderatus est, quo fit ut vis in sanguine Tamsulosini (inhibitoris receptoriorum alpha-1) augeatur.^[4]

Usus Diltiazemi

Usus medicus

Diltiazemum in hypertonia et tachycardia et fibrillatione atriali^[5] tractandis adhibetur.

Dosis diurna definita (DDD) Diltiazemi est 0.24 g (=240 mg) mg per die p.o.^[6]

Notae

↑ http://goldbook.iupac.org/B00658.html
↑ Romano A, Pietrantonio F, Garcovich A, Rumi C, Bellocci F, Caradonna P, Barone C (1992). "Delayed hypersensitivity to diltiazem in two patients". Ann Allergy 69 (1): 31-2 .
↑ Pea F (2017). "β-Blockers and Diltiazem Combination-Bear in Mind the Risk of Heart Block". JAMA Intern Med 177 (10): 1543-3
↑ Byeon JY, Lee YJ, Kim YH, Kim SH, Lee CM, Bae JW, Jang CG, Lee SY, Choi CI (2018). "Effects of diltiazem, a moderate inhibitor of CYP3A4, on the pharmacokinetics of tamsulosin in different CYP2D6 genotypes". Arch Pharm Res 41 (5): 564-70 .
↑ Means KN, Gentry AE, Nguyen TT (2018). "Intravenous Continuous Infusion vs. Oral Immediate-release Diltiazem for Acute Heart Rate Control". West J Emerg Med 19 (2): 417-22 .
↑ Systema classificationis Anatomicum Therapeuticum Chemicumque, cap. N06AA cum Diltiazemi referentia

[1] ttp://goldbook.iupac.org/B00658.html

[2] Romano A, Pietrantonio F, Garcovich A, Rumi C, Bellocci F, Caradonna P, Barone C (1992). "Delayed hypersensitivity to diltiazem in two patients". Ann Allergy 69 (1): 31-2 .

[3] Pea F (2017). "β-Blockers and Diltiazem Combination-Bear in Mind the Risk of Heart Block". JAMA Intern Med 177 (10): 1543-3

[4] Byeon JY, Lee YJ, Kim YH, Kim SH, Lee CM, Bae JW, Jang CG, Lee SY, Choi CI (2018). "Effects of diltiazem, a moderate inhibitor of CYP3A4, on the pharmacokinetics of tamsulosin in different CYP2D6 genotypes". Arch Pharm Res 41 (5): 564-70 .

[5] Means KN, Gentry AE, Nguyen TT (2018). "Intravenous Continuous Infusion vs. Oral Immediate-release Diltiazem for Acute Heart Rate Control". West J Emerg Med 19 (2): 417-22 .

[6] Systema classificationis Anatomicum Therapeuticum Chemicumque, cap. N06AA cum Diltiazemi referentia

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