CalciumChannelBlockers Flashcards
What are the dihydropyridine CCM we need to know
o Nifedipine
o Amlodipine
o Felodipine
What are the other, Type 1, CCB we need to know
o Verapamil
o Diltiazem
Type 1 CCM should not be taken with?
BetaBlocker
(verapamil and dilt)
CCM indications
angina, HTN, and selected tachyarrhythmias. Unlabeled indications include migraine headache prophylaxis, Raynaud’s syndrome, cardiomyopathy, and esophageal spasm
MOA of CCBs
Block influx of calcium in the inner side of the membrane
Where do CCM have most of their effects?
relax arterial smooth muscle but have little effect on venous beds.
Effects on the conduction system of CCM
Reduction in contractility (negative inotropic) and decreases in sinoatrial (SA) and atrioventricular (AV) nodal conduction velocity also occur.
Why is verapamil used in SVT
verapamil not only affects openings of calcium channels but also decreases the rate of recovery, resulting in depression of the SA node firing rate and slowing of AV nodal conduction
CCB choice in lactation
Nifedipine
Protocol of CCB in pregnancy
Risk out weigh benefits situation
Which CCB needs renal dosing
nicardipine
Which CCB has longest half life
Amlodipine half-life of 30 to 50 hours
Which CCB has the strongest negative inotropic effects
Verapamil - should be avoided in HF patients
Dihydropyridines should also be avoided for patients with significant ______?
peripheral edema. creates venous pooling
Photosensitivity and facial telangiectasia can occur with?
amlodipine, nifedipine, and diltiazem.
Antihypertensive effects may be decreased with concurrent use of _____?
NSAID use
Which CCBs should be used for chronic Angina?
Among the dihydropyridines, The long-acting form of nifedipine (Procardia XL) is the most often prescribed. - combined with propranolol
What side effect is almost 100% common with verapamil?
Constipation is especially common with verapamil, with almost 100% of patients experiencing significant issues. Patients taking this drug should be encouraged to increase the fiber in their diet and may need to use a stool softener.
The guidelines indicate that Black patients as a group are more responsive to ___ and ____ than ____
The guidelines indicate that Black patients as a group are more responsive to diuretics and CCBs than they are to renin–angiotensin–aldosterone system (RAAS) medications
What labs should be evaluated before intiating CCBs
Liver function
Can pts taking CCB, take calcium supplements?
can be taken safely with calcium supplements; the extra calcium does not impair drug effect.
CCBs interact with which foods - increasing drug concentrations
Grapefruit
True or False: Dihydropyridines are contraindicated in unstable angina because of their potential to cause tachycardia.
True. Key word unstable.
True or False : CCB , type 1 and type 2 can be used for stable and exertional angina.
True. key word stable.
Both type 1 and type 2 CCBs are effective in the treatment of stable and exertional angina (Table 13–7). They act on both sides of the supply–demand equation: peripheral vasodilation and negative inotropism reduce oxygen demand; dilation of coronary arteries increases oxygen supply.
Medical therapy for unstable Angina includes?
nitrates, BBs, and heparin, which are effective in controlling pain, and aspirin, which reduces mortality
