CCBs Flashcards
dihydropyridine CCbs
~ Amlodipine
~ Felodipine
~ Lacidipine
~ Lercanidipine
~ Nicardipine
~ Nifedipine (Same MR brand)
~ Nimodipine
dihydropyridine CCbs side effects
ankle swelling
Flushing
Headaches
CCB and HF
AVOID verapamil/diltiazem in HF (except amlodipine) as can cause depress cardiac function
Verapamil
~ TX angina, HTN, &arrhythmias
~ highly negatively inotropic CCB = reduces cardiac output, slows HR & impair AV conduction
~ may precipitate HF, exacerbate conduction disorders, & cause hypotension at high doses & NOT used with beta-blockers
~ Constipation = most common SE
Nifedipine
relaxes vascular smooth muscle & dilates coronary & peripheral arteries
~ more effect on vessels & less on myocardium than does verapamil
~ no anti-arrhythmic activity
common side effects of Nifedipine, nicardipine, amlodipine, & felodipine
vasodilatation =
~ flushing +headache (less obtrusive after few days)
~ ankle swelling (which may respond only partially to diuretics)
Diltiazem
~ effective in most forms of angina
~ longer-acting formulation used for HTN
~ Used if beta-blockers contra-indicated or ineffective
~ less negative inotropic effect than verapamil
~ risk of bradycardia = used with caution in association with beta-blockers
~ same brand if >60mg
Nimodipine
~ smooth muscle relaxant effect acts on cerebral arteries
~ ONLY used to prevention + tx vascular spasm following aneurysmal subarachnoid haemorrhage
Nicardipine IV
tx of acute life threatening hypertension
CCB MOA
Blocks Ca-channels to reduce force of contraction, conductivity and vascular tone
overdose of CCbs
N, V, dizziness, agitation, confusion, & coma in severe poisoning.
Metabolic acidosis & hyperglycaemia may occur
~ hypotension secondary to profound peripheral vasodilatation
CCB & grapefruit juice
avoid as increases Cp of CCBs
Rate-limiting CCBs (verapamil/diltiazem) avoid in …
Heart failure
