Calcium Channel Blockers Flashcards

1
Q

Calcium Channel Blockers
Therapeutic uses

A

Calcium channel blockers slow and relax the heart.

Hypertension
Angina Pectoris
Tachycardia

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2
Q

Why are extended release calcium blockers preferred?

A

They are safer. Immediate release may cause hypertension

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3
Q

Calcium blockers cause vaso_____ of the arteries

A

Calcium blockers cause vasodilation

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4
Q

What effect do calcium blockers have on veins?

A

No significant effect on veins

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5
Q

Verapamil & Diltiazem
Effect on heart muscle

A

-Decrease force of heart’s contracting, rate of firing and electrical conductiont, HR

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6
Q

What makes nifedipine unique / different from verapamil and diltiazem?

A

-No effect on the heart
-Acts primarily on arterioles,
whereas verapamil and diltiazem act on both arterioles and the heart

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7
Q

What are the 5 hemodynamic effects of Verapamil and Diltiazem?

A

1) Blockade at peripheral arterioles - reduces arterial pressure
2) Block at arteries and arterioles of the heart - increases coronary perfusion
3) Blockade at SA node - reduces heart rate
4)Blockade at AV node decreases AV nodal conduction
5) Blockade in the myocardium - decreases the force of contraction

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8
Q

Net effects of Verapamil and Diltiazem

A

Little to no net effect on cardiac performance

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9
Q

Verapamil & Diltiazem
Therapeutic uses

A

-Angina Pectoris
-Hypertension
-Dysrhythmias - atrial flutter, atrial fibrillation, paroxysmal supraventricular tachycardia

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10
Q

Verapamil & Diltiazem
Adverse effects

A

-Constipation (less with diltiazem)
-Dizziness, headache, facial flushing
-Heart block (excessive stoppage at the AV node; HR in the 40s)

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11
Q

Verapamil & Diltiazem
Drug interactions

A

Digoxin
Beta-blockers

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12
Q

Verapamil toxicity

A

-Hypotension
-Bradycardia and AV block

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13
Q

Verapamil toxicity antidote

A

Calcium gluconate, norepinephrine, sometimes high dose insulin

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14
Q

IV verapamil for dysrhythmias can cause severe ________ ________

A

cardiovascular effects

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15
Q

How do you monitor a patient receiving IV verapamil?

A

ECG should be monitored with resuscitation equipment immediately available

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16
Q

Lowered BP activates the _____ reflex, which causes HR to go up

A

baroreceptor

17
Q

How does nifedipine affect HR?

A

Lowers BP -> activates baroreceptor reflex -> increases HR

Reflex tachycardia

18
Q

Nifedipine
Therapeutic Uses

A

Angina pectoris
Hypertension

19
Q

Nifedipine
Adverse effects

A

Flushing
Dizziness
Headache
Reflex tachycardia

20
Q

What can be combined with nifedipine to prevent reflex tachycardia?

A

Beta blocker (e.g. metoprolol)

21
Q

Which is preferred - rapid-acting or extended release nifedipine?

A

Extended release is preferred.

Rapid-acting has been associated with increased mortality in patients with MI and unstable angina

22
Q

Amlodipine is most similar to ____

A

nifedipine