Cardiovascular (Non Rate-limiting Calcium Channel Blockers)

Question 1

Examples of drugs (Non Rate-limiting Calcium Channel Blockers)

Answer 1

• Amlodipine
• Nifedipine
• Felodipine

Question 2

Mechanism of action (Non Rate-limiting Calcium Channel Blockers)

Answer 2

• Prevent cellular entry of Ca2+ by blocking L-type calcium channels.
• Myocardial and smooth muscle contractility depressed – these drugs mainly affect smooth muscle.
• Dilate coronary blood vessels and reduce afterload
• These drugs do not lower heart rate (heart rate may increase)

Question 3

Indications (Non Rate-limiting Calcium Channel Blockers)

Answer 3

• Hypertension

- Treatment of Angina

Question 4

Side-effects (Non Rate-limiting Calcium Channel Blockers)

Answer 4

• Ankle oedema (up to 15% of patients)
• Abdominal pain / Nausea
• Palpitations (up to 4.5% of patients)
• Flushing / Headache / Dizziness

Question 5

Important pharmacokinetics/pharmacodynamics (Non Rate-limiting Calcium Channel Blockers)

Answer 5

• Avoid in: Cardiogenic shock, Unstable Angina, Significant Aortic Stenosis.

Question 6

Patient information (Non Rate-limiting Calcium Channel Blockers)

Answer 6

• Compliance is important – Patients may stop Calcium Channel Blockers if they do not feel any better.
• Remind them that hypertension is asymptomatic but nonetheless a dangerous risk factor that needs controlled.
• Ankle swelling is a common side effect, hot weather making it worse.