sodium channel blockers (Ranolazine ) treatment of coronary artery disease
Mechanism of action
Before giving Ranolazine:
- There is a channel for the exchange of calcium inside coronary artery cells and sodium outside the cells, which was exchanged through the channel leading to relaxation.
- When disturbances occur in the coronary artery, it leads to the closure of this channel, the accumulation of calcium in large quantities inside the cells and coronary artery contraction occurs.
- There is a channel called late I Na that enters sodium without exchange with calcium, only sodium. As long as the sodium-calcium exchange channel is closed and sodium is already accumulated inside, calcium will not come out either .
After giving Ranolazine:
- it closes the sodium entry channel and opens the sodium exchange channel with the accumulated calcium inside the cells, so the sodium remains outside more than the inside, and calcium also leads to the occurrence of coronary artery dilation .
Uses:
- The second line is used if the nitrates do not work.
- The best medicine that is used in the case of chronic.
- Used in the treatment of arrhythmia to prevent sodium from entering the cells.
- It can be used alone without combination, and it can be used with other medications .
Side effects:
- The most common effects are dilation, which can lead to fluid outflow and edema.
- QT interval prolongation and brady arrhythmia .
Drug-Drug Interaction:
- Epilepsy drugs (phenytoin and carbamazepine)
supply a liver enzyme responsible for breaking down Ranolazine, which reduces the effect and effectiveness of the drug, so it is forced to increase the dose and the side effects increase, so it is avoid.
- clarithromycin and fungal azole :
lead to stabilization of the enzyme responsible for the breakdown of ranolazine, so its concentration in the body increases, so the toxicity of the drug increases, so it's avoid.
- This drug is contraindicated in pregnant women because it increases the expansion of the arteries in the fetus .