Calcium Channel Blockers

Question 1

Non-DHP Drug Agents

Answer 1

Verapamil

Diltiazem

Question 2

DHPs

Answer 2

Amlodipine

Nifedipine

Nicardipine

Felodipine

Isradipine

Nimodipine

Nisoldipine

Clevidipine

Question 3

Non-DHPs

Answer 3

NON SELECTIVE

Vasodilation
Negative Inotropic
Negative Chronotrope
Negative Dromotrope

*Reduces HR and BP

Question 4

DHPs

Answer 4

SELECTIVE
-Vasodilation

Less/No Cardiac Effects

• Not anti-arrythmic (no inotropic or chronotrope effects)
• only reduce BP

Potential Reflex Tachycardia

• consider balance of oxygen demand and supply in angina
• body might try to pump heart faster due to the vasodilation of your BVs

Question 5

Therapeutic Uses of DHPs

Answer 5

Hypertension

Vasodilation->reduced systemic vascular resistance->reduced BP

Question 6

Therapeutic Uses of Non-DHPs

Answer 6

ANGINA

1. increased oxygen supply
   - vasodilation leads to reduced systemic vascular resistance leads to increased coronary blood flow
   - reduced oxygen demand
2. Reduced oxygen demand
   - vasodilation leads to reduced systemic vascular resistance leads to reduced afterload
   - decreased heart rate and contracility

ARRHYTHMIAS (non-DHPs only)

• Class IV anti-arrhythmics; prolonged phase 2 of cardiac AP
• atrial fibrillation/flutter; PSVT

Question 7

DHPs Side Effects/ Precautions

Answer 7

Side effects:
-Peripheral Edema

• Flushing, palpitations, reflex tachycardia, hypotension, dizziness and fatigue
• can lower HR TOO much —>hypotension

Precautions:

• Risk of exacerbating angina: due to reflex tachycardia
• precipitating arrhythmias

Question 8

Diltiazem Side Effects/Precautions

Answer 8

Side Effects:
-Constipation

Precautions:
-Congestive Heart Failure

Question 9

Verapamil Side Effects/Precautions

Answer 9

Side effects:

• constipation, but less so than Diltiazem
• was put created and put on the market to reduce side effects of Diltiazem