Calcium channel blocker Flashcards
what are calcium channel blocker? And whats their function
block calcium channels which lead to vasodilation and a drop in pressure very useful in hypertension cuz we know that calcium causes vasoconstriction and lead to vasodilation when blocked.
do you give em monotherapy or in combination
they can be used both in monotherapy or combinations with other drugs
can they be used in renal failure?
yes they do not affect the RAAS system so no effect on kindeys
what are the 3 groups of cc and give examples of calcium channel blockers?
1- Dihydropyridines ( PINE ) —> Nifidipine (prototype ) w اخواته bl pine
2- Phenylalkylamines —-> verapamil ( prototype )
3- Benzothiazepine —–> Diltazem (prototype )
what is most common type of voltage gated calcium channels found in cardiovascular system
L type voltage gated cc, L = long
what its the speciality of each cc family
Dihydropyiridines ( nifidipine ) —> WORK MAINLY ON BLOOD VESSELS
Phenylalkyamines and benzothiazepines —-> WORKS mainly on Heart ( Negative inotropic effect ) and has minimum effect on vessels .
verapamil and diltazem –> inhibit heart contractility and rate and heart rate.
Nifidipine –> Vasodilation of all vessels specially coronary and decreases blood pressure BUT LEAD TO REFLEX TACHYCARDIA
CCB can also inhibit platelet aggregation and insulin release
what are the actions of DHP -nifidipine ?
WORKS MAINLY ON VESSESL :
Vasodilation of blood vessels
Vasodilation of coronary arteries
Causes reflex tachycardia –> لعنه
what are the uses of nifidipine?
1- Hypertension
2- Prinzemetal angina (ONLY AND CONTRAINDICATED IN OTHER TYPES OF ANGINA CUZ REFLEX TACHYCARDIA)
what are the contraindications of nifidipine ?
1- angina that is not prinzemetal cuz of tachycardia
2- HOCM Hypertrophic obstructive cardiomyopathy cuz tachycardia
what are the uses of DAA, verapamil
1- antiarrhythmic cuz it depresses the heart
2- Hypertension
3- angina
4- SUPRAVENTICULAR TACHYCARDIA THAT IS NOT WPS AND VENTICULAR TACHYCARDIA
5- HOCM , for hocm any negative inotropic effect drug is good, quinidine, dyrparamide, bb, anything that inhibits the heart
When is verapamil contraindicated
Wolf parkinson syndrome
venticular tachycardia
what are the uses of diltiazem ?
similar to verapamil uses : hypertension and angina
what are the contraindications of diltiazam
similar to verapamil
what are the actions of diltiazam
depresses the heart like verapamil but less effects
Adverse effect:
1 constipation : due to relaxation of muscles due to the blockage of calcium
2-heart failure : due to overdepression of heart –> verapamil, diltiazam ( THIS SIDE EFFECT VERAPMIL , DILTIAZAM EXCLUSIVELY NOT NIFIDIPNE CUZ IT DOESNT WORK ON HEART )
3- Disrupt heart conduction due to over depression : this is also exclusively to verapmil, diltiazam and not nifidipine cuz it doesnt work on heart
4- increase ischemic chest pain : this is nifidine exclusive happnes to due reflex tachycardia .
5- Vascular headache , Percipitation of migrates (MIGRATES IS DUE TO NIFIDPINE ), Flushing, Postural hypotension
6- peripheral edema due to the DHP ( nifidpine w his sisters )
7- gingival hyperplasia due to verapamil/nifidipine
