CalciumChannelBlockers

Question 1

What are the dihydropyridine CCM we need to know

Answer 1

o Nifedipine
o Amlodipine
o Felodipine

Question 2

What are the other, Type 1, CCB we need to know

Answer 2

o Verapamil
o Diltiazem

Question 3

Type 1 CCM should not be taken with?

Answer 3

BetaBlocker
(verapamil and dilt)

Question 4

CCM indications

Answer 4

angina, HTN, and selected tachyarrhythmias. Unlabeled indications include migraine headache prophylaxis, Raynaud’s syndrome, cardiomyopathy, and esophageal spasm

Question 5

MOA of CCBs

Answer 5

Block influx of calcium in the inner side of the membrane

Question 6

Where do CCM have most of their effects?

Answer 6

relax arterial smooth muscle but have little effect on venous beds.

Question 7

Effects on the conduction system of CCM

Answer 7

Reduction in contractility (negative inotropic) and decreases in sinoatrial (SA) and atrioventricular (AV) nodal conduction velocity also occur.

Question 8

Why is verapamil used in SVT

Answer 8

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

Question 9

CCB choice in lactation

Answer 9

Nifedipine

Question 10

Protocol of CCB in pregnancy

Answer 10

Risk out weigh benefits situation

Question 11

Which CCB needs renal dosing

Answer 11

nicardipine

Question 12

Which CCB has longest half life

Answer 12

Amlodipine half-life of 30 to 50 hours

Question 13

Which CCB has the strongest negative inotropic effects

Answer 13

Verapamil - should be avoided in HF patients

Question 14

Dihydropyridines should also be avoided for patients with significant ______?

Answer 14

peripheral edema. creates venous pooling

Question 15

Photosensitivity and facial telangiectasia can occur with?

Answer 15

amlodipine, nifedipine, and diltiazem.

Question 16

Antihypertensive effects may be decreased with concurrent use of _____?

Answer 16

NSAID use

Question 17

Which CCBs should be used for chronic Angina?

Answer 17

Among the dihydropyridines, The long-acting form of nifedipine (Procardia XL) is the most often prescribed. - combined with propranolol

Question 18

What side effect is almost 100% common with verapamil?

Answer 18

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.

Question 19

The guidelines indicate that Black patients as a group are more responsive to ___ and ____ than ____

Answer 19

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

Question 20

What labs should be evaluated before intiating CCBs

Answer 20

Liver function

Question 21

Can pts taking CCB, take calcium supplements?

Answer 21

can be taken safely with calcium supplements; the extra calcium does not impair drug effect.

Question 22

CCBs interact with which foods - increasing drug concentrations

Answer 22

Grapefruit

Question 23

True or False: Dihydropyridines are contraindicated in unstable angina because of their potential to cause tachycardia.

Answer 23

True. Key word unstable.

Question 24

True or False : CCB , type 1 and type 2 can be used for stable and exertional angina.

Answer 24

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.

Question 25

Medical therapy for unstable Angina includes?

Answer 25

nitrates, BBs, and heparin, which are effective in controlling pain, and aspirin, which reduces mortality