Calcium Channel Blockers
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| CCB have their greatest effects on: | the heart and blood vessels
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| What are CCBs used to treat? | - hypertension
- Angina pectoris
- cardiac dysrhythmias
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| Critical Role that CCB play? | - function of vascular smooth muscle (VSM)
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| CCBS act selectively on? | - peripheral arterioles and arteries
- no effect on veins
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| Nifedipine | - works on arterioles
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| verapamil & diltiazem | - works on arterioles AND heart
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| Verapamil | - blocks ca channel in blood vessels and in the hearts
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| Verapamil uses: | - angina (widely used)
- essential hypertension (2nd line agent after Thiazide diuretics)
- cardiac dysrhythmias (given IV)
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| 5 direct effects of Verapamil: | 1. Decrease of AV nodal conduction (most important**)
2. blockade at peripheral arterioles causing dilation and reducing arterial pressure
3. Block at arterioles and arteries of heart to increase coronary perfusion
4 & 5
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| Indirect (reflex) effect of Verapamil | - lowers blood pressure which activates baroreceptor reflex
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| Does Verapamil have net effect on the heart? | NO
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| Verapamil administration | - given orally or IV
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| Verapamil ADVERSE EFFECTS | - CONSTIPATION ** Most common
- bradycardia
- Gingival hyperplasia
- Chronic eczematous rash
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| Verapamil food and drug interactions | - Digoxin
- Beta Blockers
- Grapefruit Juice
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| What is used to remove Verapamil from the GI tract in toxicity? | - gastric lavage followed by activated charcoal
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| DILTIAZEM | - Blocks ca channels in heart and vessels like Verapamil
- used for angina, essential hypertension, cardiac dysrhythmias
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| DILTIAZEM side effects: | - less constipation than Verapamil
most common:
- dizziness
- flushing
- headache
- edema of ankles and feet
-Chronic eczematous rash
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| DILTIAZEM food and drug interaction | - beta blockers
- digoxin
- grapefruit juice
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| NIFEDIPINE | - Works on arterioles but NOT the heart
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| Indirect effects of NIFEDIPINE | - Activated baroreceptor reflex
(reflex occurs mainly with IMMEDIATE-RELEASE formulation of Nifedipine)
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| SAFETY ALERT NIFEDIPINE** | - Immediate release has been associated with increased mortality in patients with MI & unstable angina
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| NET EFFECTS OF NIFEDIPINE | 1. lowers BP
2. Increases HR
3. Increases contractile force
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| NIFEDIPINE uses: | - Angina
- Hypertension
- Suppress preterm labor
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| NIFEDIPINE adverse effects: | - Reflex tachycardia**:combine with beta blocker to prevent
- flushing, dizziness, headache, peripheral edema, gingival hyperplasia
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| NIFEDIPINE drug interactions | - Beta blockers (although used for relex tachycardia)
- Toxicity can occur
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Created by:
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