Local treatment of a chronic anal fissure with diltiazem vs. nitroglycerin. A comparative study

Puche, José; García-Coret, María José; Villalba, Francisco L.; Ali-Mahmoud, Ismail; Roig, José V.

doi:10.1016/s2173-5077(10)70052-1

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…Conservative treatments aim to break the vicious circle of spasm and pain in this disorder. Nitroglycerin ointments have been reported to be effective in treatment by providing a significant increase in blood flow and decreasing anal pressure (15). A calcium channel blocker, diltiazem, has been suggested for patients who are refractory to glyceryl trinitrate (16).…”

Section: Discussionmentioning

confidence: 99%

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

Peker¹,

Yılmaz²,

Demiryılmaz³

et al. 2014

Turk J Med Sci

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Section: Discussionmentioning

confidence: 99%

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

Peker¹,

Yılmaz²,

Demiryılmaz³

et al. 2014

Turk J Med Sci

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“…There are currently a variety of products available for the treatment of chronic anal fissure, and varying success rates are reported with these products [3]. The reported success rates according to some of these products are as follows: botulin toxin (65-86 %) [5,[9][10][11][12][13], glyceryl trinitrates (48-86 %) [14][15][16][17][18][19][20][21][22][23][24][25], calcium channel blockers (42-75 %) [26][27][28][29][30], and isosorbide dinitrate (50-85 %) [31][32][33][34]. These studies were performed with the same medications, and they all had different success rates without any meaningful explanation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Chronic Anal Fissure Components on Isosorbide Dinitrate Treatment

Arslan¹,

Erenoğlu²,

Doğru³

et al. 2012

World j. surg.

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“…Out of three classes (phenylalkylamines, dihydropyridines and benzothiazepines) of Ca + channel blockers available for clinical use, DTH, (2S,3S)-5-[2-(dimethylamino) ethyl]-2-(4-methoxyphenyl)-4-oxo-2,3,4,5-tetrahydro-1, 5-benzothiazepin-3-yl acetate hydrochloride belongs to benzothiazepines class [2]. Apart from its antihypertension application, DTH is also a drug of choice in the management of classical and vasospastic angina pectoris, supraventricular tachyarrhythmias and anal fissure [3]. Oral administration of DTH subjected to extensive and complex biotransformation (N-demethylation, O-demethylation and deacetylation) which limits the biological half-life to 3-5 h and bioavailability up to 40% [4].…”

Section: Introductionmentioning

confidence: 99%

Transdermal delivery of Diltiazem HCl from matrix film: Effect of penetration enhancers and study of antihypertensive activity in rabbit model

Parhi

Suresh²

2016

Journal of Advanced Research

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The present investigation focused on the development of Diltiazem HCl (DTH) matrix film and its characterization by in-vitro, ex-vivo and in-vivo methods. Films were prepared by solvent casting method by taking different ratios of hydroxypropyl methylcellulose K4M (HPMC K4M) and Eudragit RS100. Various parameters of the films were analyzed such as mechanical property using tensile tester, interaction study by Fourier transform infrared spectroscopy (FTIR) and Thermogravimetric analysis (TGA), in-vitro drug release through cellulose acetate membrane, ex-vivo permeation study using abdominal skin of rat employing Franz diffusion cell, and in-vivo antihypertensive activity using rabbit model. The FTIR studies confirmed the absence of interaction between DTH and selected polymers. Thermal analysis showed the shifting of endothermic peak of DTH in film, indicating the dispersion of DTH in molecular form throughout the film. Incorporation of 1,8-cineole showed highest flux (89.7 μg/cm(2)/h) of DTH compared to other penetration enhancers such as capsaicin, dimethyl sulfoxide (DMSO), and N-methyl pyrrolidone (NMP). Photomicrographs of histology study on optimized formulation (DF9) illustrated disruption of stratum corneum (SC) supporting the ex-vivo results. The in-vivo antihypertensive activity results demonstrated that formulation DF9 was effective in reducing arterial blood pressure in normotensive rabbits. SEM analysis of films kept for stability study (40 ± 2 °C/75% ± 5%RH for 3 months) revealed the formation of drug crystals which may be due to higher temperature. The findings of the study provide a better alternative dosage form of DTH for the effective treatment of hypertension with enhanced patient compliance.

show abstract

Local treatment of a chronic anal fissure with diltiazem vs. nitroglycerin. A comparative study

Cited by 8 publications

References 38 publications

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

Effect of Chronic Anal Fissure Components on Isosorbide Dinitrate Treatment

Transdermal delivery of Diltiazem HCl from matrix film: Effect of penetration enhancers and study of antihypertensive activity in rabbit model

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