Calcium Channel Blockers Flashcards
What are the calcium channel blocking agents?
Verampamil Diltiazem Nicardipine Nifedipine Amlodipine
What is the MOA for CCBs?
relaxing the arteriolar smooth muscle and decreasing TPR
Where do CCBs work?
vascular tissue
Which type of Ca channel do CCBs block?
L type
What is the order of vasodilation from greatest to least?
dihydropyridines»_space; verampamil > diltiazem
CCBs decrease cardiac _______ and _______.
contractility and conduction
CCBs are not appropriate in what diagnosis?
heart failure
left ventricular hypertrophy
post-MI
SA or AV node conduction defects
What is the order of cardiac contractility and conduction reduction from greatest to least?
Verampamil > diltiazem»_space; dihydropyridines
How do CCBs compare to β-blockers and ACEIs?
therapeutically equivalent
CCBs are most effective in what populations?
African Americans and elderly with low-renin HTN
Efficacy is ______ when combined with ACEI, β-blockers, and methyldopa.
enhanced
What is the most commonly used group of CCBs?
dihydropyridines
What type of CCB can be carefully used in heart failure?
dihydropyridines
Verampamil and diltiazem work mostly on ________.
the heart
Dihydropyridines work mostly on the __________.
periphery
CCBs decrease Ca entry into what types of cells?
vascular smooth muscle
cardiac myocytes
SA and AV node
CCBs have a ______ ______ effect
negative ionotropic
What does negative ionotropic mean?
decreasing the force at which the heart contracts
All CCBs _______ coronary blood flow by coronary vaso_______.
increase
vasodilation
What is the order from least to greatest of the degree of increase of coronary blood flow?
dihydropyridines»_space; verampamil > diltiazem
CCBs bind to what site of the Ca channel?
α1
How are CCBs eliminated/metabolized.
hepatic metabolism
CCBs are ______ protein bound.
highly
Verampamil blocks the _________.
P-glycoprotein drug transporter
Verampamil decreases the clearance of what drug?
digoxin
What are the adverse effects of CCBs?
dizziness/headache/flushing/nausea peripheral edema myocardial ischemia GI reflux gingival hyperplasia constipation/coughing/wheezing/ rash elevated liver enzymes bradycardia
CCBs were show to ______ the incidence of CV events in the ACCOMPLISH trial.
decrease
