Calcium Channel Blockers

Question 1

Calcium Channel Blockers MOA

Answer 1

Block L-type voltage gated calcium channels

(“L-Shaped handle”)

Question 2

what are the 2 main groups of CCBs? what is the main difference between the two ?

Answer 2

1) Dihydropiridines
Blocks calcium channels in **Smooth Muscle

2)Non-Dihydropiridines**

Blocks calcium channels in Cardiac Muscle

Question 3

Name the Dihydropiridines

Answer 3

-DIPINE -suffix

• *Nife**/ DIPINE
• *Amlo**/ DIPINE
• *Nicar/** DIPINE
• *Clevi**/ DIPINE

Question 4

Name the Non-Dihydropiridines

Answer 4

Verapamil
(“very vannilla” flavor)

Diltiazem
(“Delicious dark choclate” flavor)

Question 5

Non-Dihydropiridines MOA

(“Non-Dairy” section”)

Answer 5

-Block L-type voltage gated calcium channels in Cardiac muscle

• decrease cardiac contractility
  (“weak kid trying to squeeze out some ice cream from the nozzle”)
• ​decrease activity of SA and AV nodes
  (“Music notes on non-dairy sign”)

⇒ may cause bradycardia​
(“Low dangling heart pocket watch”)

• ​ act as a negative ionotrope and chronotrope thus decrease myocardial oxygen demand
  (“discarded oxygen line”)
• Verapamil → very minimal dilatory activity
  (“Small sized ice-cream nozzle”)

Diltiazem → has some vasodilatory activity​
(“Medium sized ice-cream nozzle”)

Question 6

Dihydropiridines MOA

Answer 6

Block L-type Calcium Channels found in cardiac muscle

• vasodilate coronary arteries. (“dilatd coronary crown”)
• Reduce coronary resistance, increase coronary blood flow and may enhance development of collaterals

​-increased peripheral vasodilation

• lower systemic blood pressure
• ​ decrease myocardial oxygen demand
  (“discarded oxygen line”)
• ​reduce afterload
  (“reducued navil load because no ice-cream inside”)

Question 7

Calcium Channel Blockers Can Treat …

Answer 7

-CCB’s treat hypertension
(“High pressure pipes”)

-CCB’s treat stable angina
(“angina anvil”)

-CCB’s treat prinzmetal angina
(“Anvil medal on red crown lady”)

Question 8

what can Non-Dihydropiridines be used for?

Answer 8

-Verapamil can be used for Migraine Prophylaxis
(“pounding headbell”)

-they have antiarrhythmic properties, this will help with A .Fib and A .Flutter
(“Jukebox with records”)

Question 9

what can Dihydropiridines be used for ?

Answer 9

-IV dihydropyridines such as Clevidipine and Nicardipine can treat hypertensive emergency
(“Emergency shut off switch”)

-Nifedipine is used to treat hypertension in pregnancy or post-partum
(“Pregnant knife lady”)

-Nifedipine and Amlodipine can treat raynaud’s syndrome-an exaggerated response to cold temperature or stress
(“guy in toppings stand has blue fingertips”)

-can be used to treat subarachnoid hemorrhages commonly associated with berry aneurysms
(“brain shaped ice-cream with berries”)

• Nimodipine prevents vasospasms after a subarachnoid hemorrhage, vasodilates cerebral vessels (berry brain ice-cream “need Mo’dippin”)

Question 10

Dihydropiridines Side Effects

Answer 10

• CCB’sc an worsen heart failure due to hypotension, and can increase sympathetic activity
• Short acting Nifedipine has a high chance of side effects because of how active it is.
• Nifedipine can exacerbate myocardial ischemia due to reflex tachycardia – avoid in patients with unstable angina or MI
  (“Knife cutting heart shaped apple”)
• Dihydropiridines ​can cause reflex tachycardia, especially with Nifedipine
  (female doctor holding “Heart reflex hammer”)

-can cause lightheadedness, Headache, flushing,
(“lightheaded monkey customer”)

-Peripheral edema due to preferential dilation from precapillary vessels from the arterioles increased capillary hydrostatic pressure

(“ monkey customer wearing Baggy pants”)

(“failing heart balloon”)

Question 11

Non-Dihydropiridines Side effects

Answer 11

-verapamil can cause constipation
(“Clogged toilet)

-verapamil can cause gingival hypertrophy
(“toilet plummer has expanding gum in his mouth”)

-verapamil and diltiazem care relatively contraindicated in patients with heart block
(“remain unblocked” sign next to door)

-Verapamil or diltiazem combined with a beta blockers may produce excessive AV block
(“remain unBlocked” sign next to door)