Calcium Channel Blockers

Question 1

There are 2 main types of calcium channel blockers, what are they and how do they work?

Answer 1

• Rate limiting CCBs (used in Angina & HTN)
  
  • Verapamil - highly negatively inotropic
  • Diltiazem - less negatively inotropic.
• Dihydropyridines (AF) - Nifedipine, Amlodipine, Felodipine - affects the peripheral vascular smooth muscle more than the myocardium.

Question 2

Which CCB can be used alongside with a BB to rate control AF?

Answer 2

Diltiazem

Question 3

Which CCB SHOULD NEVER be used alongside with a BB?

Answer 3

Verapamil

Question 4

What CCB should never be used in heart failure?

Answer 4

Verapamil

Question 5

What caution should be advised when prescribing Diltiazem?

Answer 5

Though, less negatively ionotropic than verapamil,:

Therefore use caution when prescribing it with beta blockers or in heart failure

Question 6

In patients that are hypertensive with heart failure, what is an appropriate CCB that can be used to control their hypertension?

Answer 6

Amlodipine

Question 7

What type of CCB is used in Raynaud’s?

Answer 7

Dihydropyridines

(e.g Nifedipine)

Question 8

What are the side effects of verapamil?

Answer 8

• Constipation
• Heart failure
• Hypotension
• Bradycardia
• Flushing

Question 9

What are the side effects of Diltiazem?

Answer 9

• Hypotension
• Bradycardia
• Heart Failure
• Ankle Swelling

Question 10

What are the side effects of Dihydropyridines (Nifedipine, Amlodipine, Felodipine)?

Answer 10

• Flushing
• Headache
• Ankle swelling