Şerife CANBOLAT, Kısmet Esra NURULLAHOĞLU ATALIK

Kalsiyum Kanal Blokerlerinin Pleiotropik Etkileri

Kalsiyum kanal blokerleri, hipertansiyon, angina, periferik vasküler bozukluklar ve bazı aritmiler gibi kardiyovasküler hastalıkların tedavisinde yaygın olarak kullanılan bir ilaç grubudur. Kalsiyum kanal blokerlerinden özellikle daha yeni, daha uzun etkili olanlar, daha düşük yan etki profilleri ile hipertansiyon tedavisinde oldukça etkilidir. Bu ilaçlar, damar düz kası ve kalp hücrelerinde, sitoplazma membranındaki voltaj-bağımlı kalsiyum kanallarına veya reseptörlere yüksek afinite ile bağlanarak kalsiyum girişini azaltırlar, özellikle arteriyollerde düz kasları gevşeterek güçlü vazodilatasyon yaparlar. Voltaj-bağımlı kalsiyum kanallarının çoğunlukla L-tipine bağlanırlar. Yakın zamanda yapılan çalışmalar, bazı kalsiyum kanal blokerlerinin N- ve T-tipi kanallara da bağlandığını göstermiştir. Bunlardan N-tipi kanallar sempatik sinir uçlarında, T-tipi kanallar ise kardiyak sinus nodu ile afferent ve efferent arteriyollerde bulunur. Bu iki tip kanalın blokajı, glomerüler kapiller basıncın azalmasına, renin-anjiotensin-aldosteron sisteminin ve sempatik sinir sisteminin stabilizasyonuna neden olur. Sonuçta, özellikle yeni jenerasyon kalsiyum kanal blokerleri, renoprotektif, vasküler endotel koruyucu etki ve kardiyoprotektif etkiler gibi pleiotropik etkiler olarak tanımlananan etkilere sahiptirler.

Anahtar Kelimeler:

kalsiyum; blokör; pleiotropik etkiler

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