CCBs Flashcards
1
Q
MOA - general
A
- Blocks Ca from entering the muscle cells of heart and arteries
- Muscle relaxation = arteries widen
- Reduces pressure
2
Q
Types of CCB
A
- RL - V,D
- Dihydropyridines - A, F, N
3
Q
Dihydropyridines vs RL
A
- influence on vessels
- less on mycoardium
4
Q
Effects of RL CCB
A
- Vasodilatory
- decrease myocardial contractility + HR
- Highly negative inotropic effects (weaken force of muscle contraction of the heart)
5
Q
Which CCB should be avoided in HF
A
- RL
- Decrease myocardial contractility
- In HF, contractility is weakened already
6
Q
Can you give
the dihydropyridine CCBs in heart failure?
A
- Avoid short acting (nifedipine)
- NICE CKS recommends Amlodipine (or Felodipine) in heart failure
- Safest: amlodipine
7
Q
Which dihydropyridine
CCB is short-acting?
A
- Nifedipine
- This is why they are commonly prescribed as
Modified release preparations - Since they are short-acting, they MUST be avoided in heart failure
8
Q
Which dihydropyridine CCBs are long-acting?
A
Amlodipine
Felodipine
9
Q
Verapamil + BB
A
Avoid - brady + cardiodepression
10
Q
Verapamil - common SE
A
Constipation
11
Q
Which has a better negative inotropic effect, Verapamil or diltiazem?
A
Verapamil
more likely to cause significant myocardial depression
12
Q
Can Diltiazem be taken with Beta-blockers?
A
- Caution + specialist
- Although it has a negative inotropic effect (so there is a risk of bradycardia), the effects are not as great as Verapamil
13
Q
Dihydropyridines - SE
A
- **Ankle swelling/oedema **
- Headache
- flushing
14
Q
Does the oedema side effect of the
dihydropyridine CCBs
respond to diuretics?
A
- They only respond partially to diuretics
15
Q
Ankle swelling switch to
A
- alternative CCB
- from Amlodipine to Felodipine) if they complain about ankle swelling
