Calcium channel blockers (CCB) are the drugs prescribed for high blood pressure and hypertension to treat angina and other related symptoms.
Calcium channel blockers can be further divided into two main types depending on the type of derivative. The two major types of CCB are dihydropyridine and non-Dihydropyridine.
Key Takeaways
- Dihydropyridine calcium channel blockers primarily target blood vessels to lower blood pressure.
- Non-dihydropyridine calcium channel blockers affect the heart and blood vessels, impacting heart rate and blood pressure.
- Both are types of calcium channel blockers used to treat cardiovascular conditions but differ in their target areas and effects.
Dihydropyridine vs Non-Dihydropyridine
Dihydropyridines are a class of medications that selectively block calcium channels in smooth muscle cells of blood vessels, resulting in the relaxation of the blood vessels and increased blood flow. Non-dihydropyridines block calcium channels, reducing heart rate and lowering blood pressure.
Dihydropyridine is a type of CCB prescribed to treat hypertension, and cerebral vasospasm, stabilize angina, and reduce vascular resistance, Raynaud’s syndrome, and other related symptoms.
The potency of the drug as a vasodilator is more. The depressive effect is lower.
On the other hand, Non-Dihydropyridine is a type of CCB which is prescribed to treat tachydysrhythmias, hypertension, abnormal rhythm of the heart, atrial fibrillation, paroxysmal supraventricular tachycardia, and other related symptoms.
It is also used for nerve damage caused by diabetes or kidney diseases. The potency of the drug as a vasodilator is less. The depressive effect is higher.
Comparison Table
| Parameters of Comparison | Dihydropyridine | Non-Dihydropyridine |
|---|---|---|
| Definition | The selectivity for vascular calcium channels is of the moderate level | The selectivity for vascular calcium channels is of low to intermediate level |
| Calcium channel selectivity | The selectivity for vascular calcium channel is of the moderate level | Heartburn, dizziness, headache, swelling of the hand, foot, and ankles, flushing or temporary redness, heartburn, lightheadedness, fluctuations in the blood pressure |
| Vasodilatory effects | High vasodilatory effects | Comparatively low vasodilatory effects |
| Side effects | Heartburn, dizziness headache, swelling of the hand, foot, and ankles, flushing or temporary redness, heartburn, lightheadedness, fluctuations in the blood pressure | Tiredness, low heart rate or bradycardia, cardiotoxicity, constipation, atrioventricular block, gingival hyperplasia, reduction in contractility of the heart |
| Examples | Aranidipine, amlodipine, benidipine, barnidipine, azelnidipine, clevidipine | Verapamil, fendiline, gallopamil |
What is Dihydropyridine?
Dihydropyridine, or DHP, is referred to as an organic compound. The chemical formula of the compound is CH2(CH=CH)2NH.
The organic compound is mostly used to manufacture drugs for hypertension or L-type calcium channel blockers. The working of the calcium channel blocker is through systemic vascular vasodilation.
The molar mass of the compound is 81.1158 grams per mole. The compound shows a recurring feature because the substituents are present at 2- and 6- positions.
Dihydropyridine is also known as enamines because the compound tends to hydrolyze or tautomerize. The organic compound shows the property of oxidation in most reactions.
Most of the oxidation reactions of dihydropyridine yield a pyridine from the reaction. However, dihydropyridine, which occurs naturally and contains an N-alkyl group, does not yield pyridine from the oxidation reaction.
The product of such a reaction is an N-alkyl pyridinium cation. The PubChem ID of the organic compound is 104822.
The mechanism of dihydropyridine in drugs is to bind and block voltage-gated L-type calcium channels which are present in the smooth muscle cells of the arterial blood vessels.
The opening of such channels is in response to some action potential or electrical signal. The drug acts as a potent vasodilator. However, it is not prescribed for patients with ischemic symptoms and nephropathy.
What is Non-Dihydropyridine?
Non-dihydropyridine or non-DHP are organic molecules that belong to the class of antiarrhythmic drugs and act as calcium channel blockers.
The derivation of the organic compound is from phenylakylamine and benzothiazepine. The drugs of non-dihydropyridine can reduce myocardial oxygen, treat angina, and reverse coronary vasospasm.
The selectivity of the drug for the myocardium can reduce heart rate and has fewer effects on the blood vessels.
The vasodilatory effects of non-dihydropyridine are minimal compared to other calcium channel blocker organic compounds. The potency of the drug as a calcium channel blocker is comparatively less.
The drug also has a few cases related to reflex tachycardia, which is common for most other CCBs. The depressive effects of non-Dihydropyridine are higher, especially on cardiac conduction and contractility.
Non-Dihydropyridine drugs can be sub-classified into benzothiazepine drugs.
The drugs derived from benzothiazepine are positioned as an intermediate between dihydropyridine and phenylakylamine, as the selectivity for vascular calcium channels lies in an intermediate position.
The drug is most commonly used to reduce arterial pressure and systemic vascular resistance.
Apart from the common advantages of CCB, non-Dihydropyridine is also prescribed for diabetic nephropathy and to manage chronic kidney disease.
The drug is also effective in the reduction of cardiac arrhythmias and to reduce proteinuria. The drug also contains a fixed dose of ACE inhibitor, reducing the chances of adverse effects and improving adherence to the drug.
Main Differences Between Dihydropyridine and Non-Dihydropyridine
- Dihydropyridine acts on the vascular arteries for systemic vasodilation as a calcium channel blocker, while non-Dihydropyridine acts on the myocardium selectively as a calcium channel blocker.
- Dihydropyridine has fewer negative inotropic effects, while non-Dihydropyridine has comparatively more negative inotropic effects.
- Dihydropyridine molecules are derived from dihydropyridine compounds, while non-Dihydropyridine is derived from phenylalkylamine and benzothiazepine.
- Types of dihydropyridine are clevidipine, amlodipine, benidipine, aranidipine, barnidipine, azelnidipine, and others while types of non-Dihydropyridine are verapamil, fendiline, and gallopamil.
- Dihydropyridine has high vasodilatory effects while non-Dihydropyridine has comparatively low and minimal vasodilatory effects.
- Dihydropyridine causes more reflex tachycardia while non-Dihydropyridine causes less reflex tachycardia.
- https://link.springer.com/chapter/10.1007/978-3-642-70499-4_24
- https://journals.lww.com/jaapa/Fulltext/2012/03000/How_do_dihydropyridine_and_nondihydropyridine_CCBs.2.aspx
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