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Calcium channel blocking drugs for Duchenne muscular dystrophy

Duchenne muscular dystrophy is a progressive wasting condition of muscles which starts in early childhood, leads to dependence on a wheelchair by the age of thirteen and respiratory failure by late teens. The condition is due to absence of dystrophin, a large muscle protein that has several functions within muscle cells. We know that calcium molecules build up in the muscle cells of people with Duchenne muscular dystrophy and this is associated with cell death. The rationale behind this review was to ascertain whether randomised controlled trials using drugs that block calcium entry into muscle would result in a reduction in progression of the condition. Although these trials were conducted over ten years ago a systematic review was not done at that time, and so a potential effect of calcium blocking drugs (antagonists) on the course of DMD may have been missed. If it were to exist, calcium antagonists might be an effective treatment in their own right or, more likely, could be used in combination with newer treatments such as corticosteroids or potential treatments such as gene related therapies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Calcium antagonists as an add‐on therapy for drug‐resistant epilepsy

There is no evidence to suggest that calcium antagonists have a useful effect on seizures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour

Calcium channel blockers have not been shown to reduce preterm birth or improve the outcomes for babies when given to women after contractions of preterm labour have been stopped.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Tocolytics for preterm premature rupture of membranes

Preterm premature rupture of membranes (PPROM) accounts for one‐third of preterm births. Infants who are born before 37 weeks may suffer from problems related to prematurity, including death. Medications that aim to stop labor are often given in an attempt to prevent preterm birth. It is unclear whether these medications should be used in women with PPROM. This review of eight studies (involving 408 women) found that these medications do not effect perinatal death, but do increase latency and may increase maternal (e.g., chorioamnionitis) and neonatal morbidity (e.g., five‐minute Apgar of less than seven and increased need for ventilation of the neonate).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Magnesium sulphate versus phenytoin for eclampsia

For women with eclampsia, magnesium sulphate is better than phenytoin for preventing further seizures and other health problems for the women and their babies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Calcium channel blockers for primary Raynaud's phenomenon

Raynaud's phenomenon is a disorder whereby blood vessels in the fingers and toes constrict and reduce blood flow, causing pain and discolouration. This is usually in response to cold exposure or emotional stress. In a small number of cases, Raynaud's phenomenon is associated with an underlying disease but, for most people, it is idiopathic (of uncertain cause, or 'primary'). Primary Raynaud's phenomenon is extremely common (especially in women), with one UK study suggesting that over 15% of the population are affected. For people with primary Raynaud's phenomenon who do not respond to conservative measures (e.g. keeping warm), calcium channel blockers represent the first line in drug treatment. Calcium channel blockers (sometimes called calcium antagonists) are drugs that affect the way calcium passes into certain muscle cells and they are the most commonly prescribed medication for primary Raynaud's phenomenon.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Prevention and treatment of postpartum hypertension

Not enough evidence to know how best to treat women with hypertension after birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Calcium channel blockers for neuroleptic‐induced tardive dyskinesia

Antipsychotic medication is associated with adverse effects, including tardive dyskinesia which is characterised by abnormal, repetitive, involuntary facial movements. Calcium channel blockers, originally developed for use in cardiovascular disorders, have been experimentally used as a treatment for tardive dyskinesia. There is currently no good quality evidence to support their use.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Calcium channel blockers for inhibiting preterm labour and birth

Preterm birth is when a baby is born between 20 and 36 completed weeks' gestation. These babies are generally more ill and are less likely to survive than babies born at term. Preterm babies are also more likely to have some disability, and the earlier the baby is born the more likely they are to have problems. Even short‐term postponement of preterm birth can improve outcomes for babies, as this gives time for the mother to be given a steroid injection to help develop the baby's lungs develop prior to birth. Short‐term postponement of preterm birth may also give the chance to transfer the mother, if required, to somewhere where there is more expert care for the baby available. Drugs used to try and stop labour are called tocolytics. The most common drugs used are betamimetics, but calcium channel blockers (CCBs) are another option. CCBs are commonly used for reducing high blood pressure, but they can also relax uterine contractions. We looked to see if CCBs were effective in postponing labour and improving outcomes for babies, and also whether CCBs were better than betamimetics and other types of tocolytics used to postpone preterm labour and birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Non surgical therapy for anal fissure.

Anal fissure is a painful ulcer usually occurring in the posterior midline of the skin just outside the entry to the rectum. Its persistence is due to spasm of the internal sphincter muscle. The typical pain of this condition is pain on moving one's bowels that persists for some time afterward. Relief with healing of chronic fissures until very recently has been achieved by surgical procedures aimed at ablation of the sphincter spasm. Because of the risk of incontinence resulting from surgery, medical alternatives for surgery have been sought. Among the older medications, bran is effective in preventing recurrence of acute fissure. Local application of muscle relaxing therapy is effective in healing chronic anal fissure, though not as well as surgery, and with considerable risk of adverse events during therapy. There is a Cochrane review related to this review dealing only with surgical procedures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Pentoxifylline for intermittent claudication

Atherosclerosis, or hardening of the arteries, results in narrowing and blockage of the arteries and can reduce the blood supply to the legs, causing peripheral arterial disease. Intermittent claudication (IC) is a cramp‐like pain felt in the leg muscles that is brought on by walking and is relieved by standing still or resting. Pentoxifylline is a drug that is used to relieve IC while improving people's walking capacity. It decreases blood viscosity and improves red blood cell flexibility, promoting microcirculatory blood flow and increasing oxygen in the tissues. This review looked at all available evidence from randomised controlled trials on the efficiency of pentoxifylline for treatment of IC.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Oxytocin receptor antagonists for inhibiting preterm labour

Tocolytic drugs suppress preterm labour and have the potential to postpone preterm birth long enough to, hopefully, improve infant outcome. This may be by allowing normal growth and maturation of the baby, or by allowing time for administration of magnesium sulphate to reduce risk of cerebral palsy and corticosteroids to help the baby's lungs and other organs to mature. They may also provide the opportunity, if necessary, for the mother to be transferred to a hospital that has facilities to provide neonatal intensive care. However, prolonging pregnancy may instead have adverse outcomes for the baby and so it is important to assess infant outcomes alongside duration of pregnancy. Oxytocin receptor antagonists (ORAs) are a group of tocolytic drugs, and we undertook this review to see if ORAs prolonged pregnancy and improved outcomes for infants compared with no treatment or with other tocolytic drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Is the blood pressure lowering effect of dihydropyridine calcium channel blockers consistent or variable throughout 24 hours?

High blood pressure, also known as hypertension, is a risk factor for adverse cardiovascular events such as stroke and heart attack. Blood pressure varies widely in an individual but certain patterns in its rise and fall have been identified in the general population; blood pressure increases in the early morning hours and decreases during the night. There is a variety of treatment options available for treating high blood pressure. Dihydropyridine calcium channel blockers are a group of drugs used to lower blood pressure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Nitric oxide for preventing pre‐eclampsia and its complications

Not enough evidence to say if nitric oxide donors or their precursors are helpful in preventing pre‐eclampsia and its complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Combinations of tocolytic drugs for inhibiting preterm labour

Preterm birth (birth before 37 weeks) is the single largest cause of deaths and ill health for newborn babies and a major cause of complications for pregnant women. Tocolytic agents include a wide range of drugs that can slow or stop labour contractions so as to prolong pregnancy and potentially improve the health outcomes for the baby. Using a combination of two or more tocolytic drugs may improve the length of time the pregnancy is prolonged over using a single tocolytic drug or no intervention, without adversely affecting the mother or baby or worsening drug side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Oral vasodilator drugs to reduce the symptoms of primary Raynaud's phenomenon

Raynaud's phenomenon is caused by short term constriction of the small arteries in the extremities, usually the fingers. For a few minutes, usually, the fingertips go white and feel numb or tingle and prickle. Then the blood flow returns and they become warm and red, which can also be painful. For some people the toes, ears, nose, tongue or nipples are affected. Cold or emotional stress can trigger the attacks. Keeping warm, stopping smoking and avoiding using tools that vibrate can prevent attacks but sometimes drug therapy is needed. Calcium channel blockers such as nifedipine are the drugs of choice but can have unwanted side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Treating kidney stones

Small kidney stones often pass on their own and don't need treatment as long as they don't cause any severe pain or complications. Larger kidney stones usually need to be removed. Depending on how large the kidney stones are and where they're located, they can be destroyed, removed using endoscopy or operated on.Kidney stones with a diameter of less than 5 millimeters pass on their own 70% of the time, and stones that are between 5 and 10 millimeters are flushed out in about 50% of cases. The amount of time this takes varies greatly. Small kidney stones are often passed in your urine after one or two weeks.If a stone is expected to be flushed out with your urine without any treatment, it's usual to simply wait. Anti-inflammatory painkillers like diclofenac can provide relief if the kidney stone causes pain as it travels through the ureter.Larger stones will usually have to be broken up or surgically removed. This needs to be done in the following instances:The kidney stone isn't passed within four weeks.There are complications.It causes severe renal colic.The stone is larger than 10 mm in diameter.Uric acid stones can sometimes be dissolved using medication.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 25, 2016

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