Proposes a theoretical mechanism where calcium channel antagonists act via magnesium-mediated pathways.
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No immediate clinical implications; leaves open experimental validation of magnesium-mediated calcium channel blocker effects.
Mg 2+ and Ca 2+ ‐channel blockers exert similar effects on the cardiovascular system. These agents have been successfully used for treating hypertension and for protecting against myocardial ischaemia. The exact mechanism of action of Ca 2+ ‐blocking drugs, including verapamil, is unknown. It is proposed that Ca 2+ ‐blockers stimulate the Mg 2+ transport system and Mg 2+ diffusion into the cell, thereby enhancing Mg 2+ influx. This, in turn, causes suppression of the slow inward Ca 2+ current and fast inward Na + current, resulting in decreased transport of Ca 2+ and Na + . Ca 2+ ‐blockers might also influence outward K + and Mg 2+ currents, thereby altering the shape and duration of the action potential. Since Mg 2+ is involved in maintaining the structural and functional integrity of the cardiovascular system, Mg 2+ ‐mediated mechanisms of action for Ca 2+ ‐antagonists appear possible.
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Singh Rb (1988) studied this question.
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