Mechanism of Tissue-Selective Drug Action in the Cardiovascular System

Table 1.

Calcium Channel Antagonists: Effects on Physiological Parameters and Therapeutic Use

		Nifedipine	Verapamil	Diltiazem
^a CV, coronary vessel. ^b ↑ denotes increase. ^c ↓ denotes decrease. ^d NE, no effect. ^e AV, atrioventricular. ^f ERP, effective refractory period. ^g + denotes degree of use. ^h Paroxysmal supraventricular tachyarrhythmias. ⁱ NU, not used. ^j Posthemorrhage. ^k Data based on nimodipine, a nifedipine analog.
Parameter
	CV^a tone	↓↓↓^b	↓↓^c	↓↓
	CV flow	↑↑↑	↑↑	↑↑
	Periferal vasodilation	↑↑↑	↑↑	↑
	Heart rate	↑↑	↓	↓
	Contractility	NE^d, ↑	NE, ↓	NE, ↓
	AV^e node conduction	NE	↓	↓
	AV node ERP^f	NE	↓	↓
Use
	Exertional angina	+++^g	+++	+++
	Prinzmetal’s/variant angina	++	+++	+++
	Unstable angina	+	+++	+++
	Arrhythmias^h	NUi	+++	++
	Atrial fibrillation/flutter	NU	++	++
	Hypertension	+++	++	++
	Hypertrophic cardiomyopathy	NU	+	NU
	Raynaud’s phenomenon	++	++	++
	Cerebral vasospasm^j	+^k	NU	NU