Calcium Channel Blockers Flashcards
Primary use of CCB?
- Angina - Selected arrhythmias - Hypertension
What happens if Ca entry into the cells is blocked?
No contraction of vasculature
What type of channel is sensitive to CCB?
L-type
CCB ADME?
well absorbed, hepatically metabolized
How does CCB for myocardium work?
Decrease BP, negative chronotropy, negative inotropy (so not good for CHF patients)
How does CCB for vasculature work?
Decrease BP, vasodilate (no effect on HR/contractility)
How does Verapamil work?
Prolongs AV node conduction, so MYOCARDIUM CCB
Use Verapamil cautiously in patients with _____
Bradycardia
Verapamil adverse reactions?
Hypotension Peripheral Edema Constipation **
How is Verapamil administered? Dosage?
IV for arrhythmias Immediate Release 80-120 mg PO TID or Covera HS qHS (circadian dosing, take with food!)
When is BP & HR highest?
early morning, 5-7am
Diltiazem effects?
Vasculature and myocardium, Antiarrhythmic agent that prolongs AV conduction
How is Diltiazem administered?
Injectable dosage to treat atrial fibrillation
Or PO
Diltiazem adverse effects? (4)
Bradycardia, Rare AV block, Peripheral edema, Flushing
Diltizaem dosages?
IR 30mg PO QID (start pt on this) SR 120-128 mg PO QD gradually increase dose over 1-2 days until desired response is achieved MAX DOSE 240-360mg/day
Cardizem SR and CD Capsules?
60-120 mg PO BID (sustained release) 180-240 mg PO QS (continuous dose)
Start patient on immediate release (short acting) cause if you screw it up it goes away
Nifedipine works how?
prevents coronary smooth muscle vasoconstriction and reduces oxygen demand Works on VASCULATURE
Nifedipine adverse effects?
Flushing/rash, Peripheral Edema, Dizziness, Gingival hyperplasia (also in anticonvulsants)
Other uses for Nifedipine?
migrane prophylaxis, achalasia (too much LES tone), Raynaud’s
Amlodipine usage? Adverse effects?
Vasculature, peripheral edema, flushing BEST FOR CHF PATIENTS much lower incidence of negative inotropic effects
What CCB is used in stroke patients?
Nimodipine (cerebral vasodilator) give after stroke
Which CCB result in non-cardiogenic peripheral edema? which in cariogenic?
Noncardiogenic- nifedipine, amlodipine
Cardiogenic- verapamil, diltiazem (decrease heart function, heart probably failing if edema present)
LOOK AT DIAGRAM
what drug to treat atrial fibrillation?
Diltiazem
