Is Angispan TR (Diltiazem) the same as Sorbiturate?

Angispan TR and Sorbiturate Are Not the Same Medications

No, Angispan TR (Diltiazem) and Sorbiturate are not the same medications. Angispan TR contains diltiazem, which is a calcium channel blocker, while Sorbiturate is a different medication class.

About Diltiazem (Angispan TR)

Diltiazem is a non-dihydropyridine calcium channel blocker with specific pharmacological properties:

• Diltiazem inhibits calcium influx through L-type calcium channels in vascular smooth muscle and myocardium, leading to smooth muscle relaxation and reduced myocardial contractility 1
• It has prominent effects on atrioventricular conduction and sinus node cells, resulting in negative inotropic and chronotropic effects 1
• Diltiazem is less selective for vasculature compared to dihydropyridine calcium channel blockers (like amlodipine) and has more pronounced effects on myocardial contractility 1

Clinical Uses of Diltiazem

• Effective in treating stable, variant, and unstable angina pectoris 2
• Used for management of hypertension 2
• Effective in terminating supraventricular tachycardia and controlling ventricular response in atrial fibrillation/flutter 2
• Particularly effective in vasospastic angina when used alone or in combination with nitrates 1

Pharmacological Classification

Diltiazem belongs to the benzothiazepine class of calcium channel blockers, which is structurally and pharmacologically distinct from other calcium antagonist families 3

Important Clinical Considerations

Contraindications and Precautions

• Diltiazem should be avoided in patients with:

  • Pulmonary edema or severe left ventricular dysfunction 1
  • Concomitant use with ivabradine due to risk of severe bradycardia 1

• Caution is needed when combining diltiazem with beta-blockers due to risk of high-degree atrioventricular block 1

Side Effects

• Major side effects include hypotension, worsening heart failure, bradycardia, and AV block 1
• Other common side effects include headache, dizziness, flushing, and leg edema 1

Comparative Efficacy

• Diltiazem has been shown to improve exercise duration by approximately 95% in patients with chronic stable angina 4
• In studies of unstable angina/NSTEMI, diltiazem reduced reinfarction and refractory angina without increasing mortality rates 1
• When compared to other calcium channel blockers like verapamil, nicardipine, and tiapamil, diltiazem demonstrated significant improvement in exercise tolerance in patients with chronic stable angina 4

Clinical Decision Making

When deciding between different antianginal medications:

• For patients with high heart rate (>70 bpm), heart-rate-lowering agents like diltiazem may be preferred 1
• For patients with vasospastic angina, calcium channel blockers including diltiazem are particularly effective 1
• In patients with chronic obstructive pulmonary disease with positive bronchoreactivity or asthma (where beta-blockers are contraindicated), diltiazem may be a preferred option 1

In summary, Angispan TR (Diltiazem) is a calcium channel blocker with specific cardiovascular effects and therapeutic applications, which is pharmacologically distinct from Sorbiturate.