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The effect of pretreatment with graded concentration of diltiazem on the inotropic responses to amrinone were studied on isolated atria of rabbit. The responses to amrinone were modified by diltiazem in a biphasic manner; initial potentiation followed by inhibition. The potentiation is proposed to be due to synergistic rise in cytosolic calcium ion concentration by diltiazem and amrinone. The inhibition by diltiazem in higher concentration may be due to blockade of calcium ion influx and depletion of intracellular calcium ion from storage sites.

Diltiazem, a calcium channel blocker was studied to observe its effects on the acetylcholine contractile responses of isolated frog rectus abdominis muscle. This response was modified in a dual manner i.e., initial potentiation, followed by inhibition. Diltiazem may not have anticholinesterase like mechanism, as it potentiated the responses to both acetylcholine and succinylcholine. Rectus muscle preparation, incubated in calcium free frog Ringer, showed dose dependent inhibition of acetylcholine contractile responses by diltiazem. The study suggests that diltiazem inhibits calcium ion influx across receptor operated calcium channels and may also inhibit calcium ion release from intracellular structures.