Calcium channel blockers (CCBs)

Question 1

MoA

Answer 1

Blocks calcium-channels to reduce force of contraction, conductivity and vascular tone.

Question 2

Dihydropyridine CCBs - MoA

Answer 2

Vasodilation = relaxation of the peripheral blood vessels.

Question 3

Dihydropyridine CCBs - examples

Answer 3

FALLN
Felodipine
Amlodipine
Lacidipine
Lercanidipine
Nifedipine (if MR = maintain on same brand)

Question 4

Dihydropyridine CCBs - side effects

Answer 4

• Headache (common)
• Ankle swelling
• Flushing
• Palpitation

Question 5

Non-dihydropyridine CCBs - MoA

Answer 5

Exert effects on cardiac muscle.

Question 6

Non-dihydropyridine CCBs - examples

Answer 6

• Verapamil
• Diltiazem

Question 7

Verapamil

Answer 7

Causes constipation
Only CCB licensed for arrhythmias
Less commonly causes:
- Bradycardia
- Heart block
- Cardiac failure

Question 8

Diltiazem

Answer 8

> 60mg = maintain on same brand

Question 9

Interactions

Answer 9

Grapefruit juice (enzyme inhibitor) - increased CCB concentrations.
Beta blockers + non-dihydropyridine CCBs = heart failure, bradycardia + asystole

Question 10

Non-dihydropyridine CCBs - caution

Answer 10

Impaired left ventricular function
Avoid in unstable angina + severe aortic stenosis