1994 issue 2

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Volume 3, issue 2

Farmakoterapia neurologiczna

Application of calcium-channel blockers in the treatment of the acute ischeamic stroke

Anna Członkowska1
1. Kliniki Chorób Naczyniowych Układu Nerwowego IPiN w Warszawie
Postępy Psychiatrii i Neurologii, 1994, 3, 165-172
Keywords: acute ischaemia of the brain, treatment, calcium channels antagonists

Abstract

Ischaemia of the brain is associated with a distinct increase in the intracellular concentration of calcium ions inside nervous cells. Calcium not only enters the nervous through calcium channels dependent both on the membrane potential and on the receptor, but also is released from intracellular stores. Due to a high concentration of calcium many abnormal metabolic processes are initiated, leading eventually to death of nervous cell. A number of experimental studies suggests that drugs inhibiting the process of increase of calcium concentration within a cell aid the cell to survive during an ischaemic episode. Clinical research findings are less optimistic. The paper presents a detailed overview of 7 clinical studies using nimodipine, a drug most frequently administered by neurologists and neurosurgeons. A positive effect of nimodipine, i.e. a reduction of neurological deficits and of motor disability, was found in only one study (published in 1992 in the USA), in which the drug was administered orally in the 120 mg/ 24-hour dose within the first 18 hours since the onset of the stroke. The administration of nicardipine and flunarizine in the acute staged of cerebral stroke has found in preliminary studies to have a positive effect, but efficacy of these drugs should be confirmed on a more extensive sample.

Address for correspondence:
Prof Anna Członkowska,
Klinika Chorób Naczyniowych IPiN,
Al. Sobieskiego 1/9,
02-957Warszawa