Calcium Channel Blockers

Question 1

During contraction of muscle Ca levels increase or decrease intracellularly?

Answer 1

Increase, once the contracion is over Ca returns to the sarcoplasmic Reticulium

Question 2

What are the 6 types of Ca Channels?

Answer 2

L N P Q R T

Question 3

Type L 5 sub units?

Answer 3

Alpha 1( main pathway) Alpha 2 Beta Gama Delta

Question 4

3 types of Calcium Channel Blockers

Answer 4

Phenylalkylamines Benzothazepines DHP’s (1,4-Dihydropyridines)

Question 5

Verapamil is a ?

Answer 5

Phenylalkylamines

Question 6

Nifedipine is a ?

Answer 6

DHP’s (1,4-Dihydropyridines)

Question 7

Diltiazem is a ?

Answer 7

Benzothazepines

Question 8

Nicardipine is a ?

Answer 8

DHP’s (1,4-Dihydropyridines)

Question 9

Amlodipine is a ?

Answer 9

DHP’s (1,4-Dihydropyridines)

Question 10

NON DHP’s (1,4-Dihydropyridines) Diltiazem and Verapamil cause

Answer 10

Negative inotropic, chronotopic and dromotropic effect and a Positive lusitropic effect (Relaxation effect)

Question 11

Ca Blockers decreased Perif vascualr Resistance by ?

Answer 11

Arteriole dilation, do not effect venous tone

Question 12

Ca Blockers cause?

Answer 12

Decrease coronary vascular resistance, and increase coronary blood flow

Question 13

KNOW THIS CHART

Answer 13

Question 14

Beta Blockers can be used with which Ca Blockers?

Answer 14

DHP’s

Question 15

Common Uses for Ca Blockers

Answer 15

Angina (vasospastic or exertional)

Unstable Angina

PSVT

HTN

Hypertrophic cardiomyopathy

Subarachnoid Hemorrhage ( Nimodipine)

Question 16

Common Side Effects of Ca Blockers

Answer 16

Orthostatic HTN

Bradycardia

perif. edema

Dizziness

HA

Flushing and N/V

Question 17

Increased AV Block can occur with Beta Blocker and Ca channel blocker concomitent use unless which Ca blocker catagory is used?

Answer 17

DHP’s

Question 18

Name 3 DHP’s

Answer 18

Nifedipine, Nicardipine, Nimodipine

Question 19

DHP’s cause the following hemodynamically?

Answer 19

Drop in BP

increase in HR (baroreceptor response)

Increased contractility

increase in CO

Question 20

Phenylalkylamines Name them

Answer 20

Verapamil is the only one

Question 21

Caution using Verapamil in patients using?

Answer 21

Beta Blockers and Digoxin

Question 22

CONTRAINDICATIONS

of

Verapamil

Answer 22

WPW

Sick sinus syndrome

AV block

Heart Failure

Question 23

Verapamil Dose

Answer 23

Initial dose: 5 to 10 mg IV bolus over at least 2 minutes
Repeat dose: 10 mg, 30 minutes after the first dose if the initial response is not adequate

Question 24

Diltiazem Dose

Answer 24

initially 0.25 mg/kg over 2 min. If inadequate give 0.35 mg/kg over 2 min-15 min after 1st dose.

Question 25

Nifedipine Dose

Answer 25

Extended release tablets: 30 to 60 mg orally once a day
Immediate release capsules: 10 mg orally 3 times a day

Question 26

Nicardipine Dose

Answer 26

Initial dose: 5 mg/hour by IV infusion
may be increased by 2.5 mg/hour every 5 minutes to a max dose of 15 mg/hour, until desired blood pressure reduction is achieved.

Question 27

Amlodipine Dose

Answer 27

2.5 - 10 mg PO QD

Question 28

Nimodipine Dose

Answer 28

IV : For the first two hours of treatment 1 mg/5ml/hr of nimodipine IV
After 2 hours to 2 mg/10ml/hr provided no severe decrease in blood pressure is observed