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CH 44: Calcium chann

Calcium Channel blockers

QuestionAnswer
What do Calcium channels do? Calcium channel blockers prevent calcium influx into the cells. (Calcium causes contraction) If you slow down the contraction of the heart, vasodilation occurs therefore decreasing BP. The work only on arteries
What are Calcium Channel blockers indicated for? HTN (main indicator) Angina some used for dysrhythmias
in addition to preventing calcium influx into the cells, What do calcium channel blockers do? Calcium channel blockers effect the SA node, slowing down the HR. They also slow the conduction of the AV node.
What are the 2 classes of calcium channel blockers? (1) Phenylalkylamines (2) Dihydropyridines
Which of the calcium channel blockers fit into the Phenylalkylamines? (1) Virapamil [Calan] (2) Diltiazem
There are 2 Calcium channel blockers taht act on vascular smooth muscle AND the heart, what are they? the 2 drugs that act on the vascular smooth muscle as well as the heart are Virapamil and Diltiazem
What route of administration is Virapamil [Calan] administered? Oral or IV
What MUST you do if your patient is on Virapamil? if your patient is on Virapamil, they MUST have their heart status monitored.
What are the indications for Virapamil [Calan]? HTN angina Dysrhythmias (particularly Afib.)
/What are the hemodynamic effects of virapamil [Calan]? Virapamil [Calan] causes vasodilation on the arteries. Blocks SA node firing Blocks AV node conduction Decreases the force of contraction
does Virapamil cause the reflex tachycardia in response to decreased BP? Why? NO. Virapamil decreases the firing of the SA node and the conduction of the AV node, therefore inhibiting the reflex tachycardia
Where is virapamil metabolized? Virapamil is metabolized in the liver. therefore if they have impaired liver function, the dose must be lowered.
What are the side effects of virapamil? Virapamil is pretty well tolerated constipation dizziness, flushed face, headache (vasodilation) heart block (dt decreased AV node conduction) Bradycardia
Who should probably not be on Virapamil? If a patient has had a Heart block, they should not be on Virapamil. Virapamil decreases the conduction of the AV node, which is what they already struggle from if they have a heart block
Drug interactions with Virapamil: Digoxin increases risk for heart block because it also suppresses the AV node there is also a risk for toxicity
What should be done if there is an overload of Digoxin? calcium gluconate
Tell me a little bit about Diltiazem: EVERYTHING Is the same as Virapamil exdcept perhaps it causes less constipation.
What drug fits into the category of Dihydropyridines? Nifedipine
What is the primary difference between Nifedipine and Virapamil? Nifedipine does NOT have calcium blockaid in the heart. Nifedipine is NOT used for dysrhythmias
What are the indications for use of Nifedipine? Nifedipine is used for HTN, angina, but NOT dysrhythmias.
If a patient is already bradycardiac or already has a heart block, what calcium channel would be best to use? why? Nifedipine is the best for patients who are bradycardic or have a heart block because there is no interference with AV node conduction
do calcium channel blockers act on arteries, veins or both? Arteries
Created by: 1398660434
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