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Hypertension > Calcium Channel Blockers > Flashcards

Calcium Channel Blockers Flashcards

1
Q

What are the calcium channel blocking agents?

A 
Verampamil
Diltiazem
Nicardipine
Nifedipine
Amlodipine
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2
Q

What is the MOA for CCBs?

A

relaxing the arteriolar smooth muscle and decreasing TPR

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3
Q

Where do CCBs work?

A

vascular tissue

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4
Q

Which type of Ca channel do CCBs block?

A

L type

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5
Q

What is the order of vasodilation from greatest to least?

A

dihydropyridines&raquo_space; verampamil > diltiazem

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6
Q

CCBs decrease cardiac _______ and _______.

A

contractility and conduction

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7
Q

CCBs are not appropriate in what diagnosis?

A

heart failure
left ventricular hypertrophy
post-MI
SA or AV node conduction defects

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8
Q

What is the order of cardiac contractility and conduction reduction from greatest to least?

A

Verampamil > diltiazem&raquo_space; dihydropyridines

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9
Q

How do CCBs compare to β-blockers and ACEIs?

A

therapeutically equivalent

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10
Q

CCBs are most effective in what populations?

A

African Americans and elderly with low-renin HTN

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11
Q

Efficacy is ______ when combined with ACEI, β-blockers, and methyldopa.

A

enhanced

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12
Q

What is the most commonly used group of CCBs?

A

dihydropyridines

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13
Q

What type of CCB can be carefully used in heart failure?

A

dihydropyridines

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14
Q

Verampamil and diltiazem work mostly on ________.

A

the heart

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15
Q

Dihydropyridines work mostly on the __________.

A

periphery

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16
Q

CCBs decrease Ca entry into what types of cells?

A

vascular smooth muscle
cardiac myocytes
SA and AV node

17
Q

CCBs have a ______ ______ effect

A

negative ionotropic

18
Q

What does negative ionotropic mean?

A

decreasing the force at which the heart contracts

19
Q

All CCBs _______ coronary blood flow by coronary vaso_______.

A

increase

vasodilation

20
Q

What is the order from least to greatest of the degree of increase of coronary blood flow?

A

dihydropyridines&raquo_space; verampamil > diltiazem

21
Q

CCBs bind to what site of the Ca channel?

A

α1

22
Q

How are CCBs eliminated/metabolized.

A

hepatic metabolism

23
Q

CCBs are ______ protein bound.

A

highly

24
Q

Verampamil blocks the _________.

A

P-glycoprotein drug transporter

25
Q

Verampamil decreases the clearance of what drug?

A

digoxin

26
Q

What are the adverse effects of CCBs?

A 
dizziness/headache/flushing/nausea
peripheral edema
myocardial ischemia
GI reflux
gingival hyperplasia
constipation/coughing/wheezing/ rash
elevated liver enzymes
bradycardia
27
Q

CCBs were show to ______ the incidence of CV events in the ACCOMPLISH trial.

A

decrease

Hypertension (8 decks)

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