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
what is clevidipine
its DHP from the pine family, its IV format
whats the relation between beta blocker and nifedipine
insane combo, really good for hypertension cuz the reflex tachycardia wont happen the bb will reset the baroreceptors.
whats the relation between bb and verapamil
really bad cuz both will depress the heart and might lead to heart failure so we cant give 2 heart depressors
whats the relation between digoxin and verapamil
verapamil increases digoxin levels in blood and increase toxicity and might lead to block.
whats the relation between DHP ( nifidpine )and grapefuit
grapefruit increases the bioavailability of nifidpine and enhance its effect
whats the relation between ccb and CYP450
cyp450 metabolizes ccbs and it may compete with other drugs.
is nifidpine good for pregnancy? if yes what are the drugs that are used during pregnancy until now
1- Methyldopa/clonidine
2- nifidpine
3- labetalol/carvedlol
what are the drugs use for emergencies
1- IV enalaprilat
2- IV labetalol
3- IV clevidipine
what drugs can be used in renal failure until now
clonidine
bb
cc
