Ca Channel Blockers Flashcards
Primary use of Ca Channel Blockers will be in what 3 areas?
Angina, selected arrhythmias, HTN
If specific to myocardium, they have what affects on inotropy, chronotropy and blood pressure?
decrease inotropy
decrease chronotropy
decrease blood pressure
if specific to vasculature, they have what effect?
vasodilate
no effect on heart
decrease BP
All CCBs are ____ absorbed and primarily metabolized by what?
well
liver (not affected by kidney disease)
What are the 3 classes of CCBs?
Phenylalkylamines (verapamil)
Benzothiazepine (diltiazem)
Dihydropyridines (nifedipine, amlodipine)
Verapamil = ___ heart and ___ vasculature.
Is it old or new?
95% heart, 5% vasculature
OLD- cheap
Diltiazen = ___ heart and ___vasculature.
50% heart, 50% vasculature
Nifedipine = ____heart and ___ vasculature.
5% heart, 95% vasculature
Amlodipine = ___ heart and ___ vasculature.
Is it old or new?
% heart, 99% vasculature
new-$$$
Is V, D, N, or A the most safe for heart failure?
V is worst, A is best
which CCBs are used for tachy-arrhythmics?
V and D because they are negative ino/chronotropy
How do CCBs affect coronary blood flow?
They all increase. Dihydro- the best.
How does verapamil work? In what patients should you use this cautiously?
Effectively prolongs AV node conduction. So, decrease HR. Be cautious with those with bradycardia.
What are AE’s of verapamil?
hypotension, CHF, peripheral edema (Cardiogenic), constipation
Which class does Covera HS belong in? What does HS indicate?
Verapamil (phenyl…)
HS- at bedtime for circadian dosing (so that it has an effect in the morning when BP is the highest)
T or F: Verapamil SR products should be taken with food or crushed.
Should be taken with food and NOT crushed.
General rule: always start with ________ release, QID,
immediate
Injectiable Diltiazem is most commonly used for______.
A Fib.
What are the AE’s of Diltiazem?
bradycardia, rare AV block, peripheral edema (cardiogenic), flushing
Cardizem SR are dosed ______., and Cardizem CD are dosed ____. These are both what class of CCBs?
SR- BID
CD-QD
Diltiazem
How do you convert from IV to PO Diltiazem?
Use IR PO dosage form and overlap by about 3 hours
Nifedipine has what AEs?
flushing/rash, peripheral edema (non-cardiogenic), dizziness, gingival hyperplasia (rare and also caused by anti-convulsants).
How if Nifedipine available?
PO
How is Diltiazem available?
IR, injectable, IV
Nifedipine has what other potential uses?
migraine prophylaxis, achalasia (increased LES tone), Raynaud’s phenomenon
Amlodipine has what AEs?
peripheral edema (non-cardiogenic), flushing
How is amlodipine available?
PO
What are some other CCBs?
Nimodipine–cerebral vasodilator (stroke)
Which CCBs may cause SOB when lying down?
V and D
How is Verapamil dosed?
IR PO TID
How do CCBs work?
inhibit Ca++ entry into cells necessary for contraction.
