Calcium and calcium antagonists in airway disease. A review

It seems unlikely that currently available calcium antagonists will become the first line drugs in the treatment of hyperreactive airway disease. It is, however, possible that newer calcium antagonists will be developed with more specific effects on bronchial smooth muscle and mast cells. Possibly, higher topical concentrations with fewer systemic side effects may be achieved by the inhaled route. The effectiveness of calcium antagonists in the treatment of cardiac conditions such as angina and supraventricular arrhythmias is well documented. In one report of 20 patients suffering from angina pectoris with coexisting fixed or labile airway obstruction, nifedipine was found to be an effective drug in controlling angina without adverse airway effects. Beta-adrenergic antagonists used in treating angina pectoris may precipitate bronchoconstriction in some patients with asthma or chronic bronchitis. Thus, patients suffering from both conditions might, therefore, be more appropriately treated with calcium antagonists than with the β-adrenergic antagonists.