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HLST220: Pharmacology > Chapter 48: Calcium Channel Blockers > Flashcards

Chapter 48: Calcium Channel Blockers Flashcards

1
Q

calcium channel blockers have the greatest impact on

A

heart and blood vessels

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2
Q

calcium channel blockers are used to treat

A

hypertension, angina pectoris, and cardiac dysrhythmias

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3
Q

calcium channel blockers are also known as

A
  • calcium antagonists
  • slow channel blockers
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4
Q

calcium channels open =

A

contractile process

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5
Q

calcium channels blocked =

A

vasodilation

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6
Q

consequences of therapeutic doses

A

selectively act on peripheral arterioles and arterioles of the heart (no significant effect in veins)

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7
Q

consequences of calcium channel blockers on the heart

A
  • myocardium (-/+ inotropic effect)
  • SA node (pacemarker, reduce heart rate)
  • AV node (decrease conduction velocity)
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8
Q

calcium channel blockers act like

A

beta blockers

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9
Q

classifications of calcium channel blockers

A
  • Dihydropyrides
  • Phenylalanine
  • Benzothiazepine
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10
Q

Dihydropyridines example

A

Nifedipine

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11
Q

Dihydropyridines act primarily on

A

arterioles

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12
Q

Phenylalanine example

A

Verapamil

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13
Q

Verapamil acts on

A

arterioles and directly on the heart and blood vessels

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14
Q

Benzothiazepine example

A

Diltiazem

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15
Q

Diltiazem act on

A

arterioles and directly on the hear and blood vessels

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16
Q

Verapamil and Diltiazem effects

A

Hemodynamic effects

17
Q

what are the 5 Hemodynamic Effects

A
  • Blockade at peripheral arterioles (reduces arterial pressure)
  • blockade at arteries and arterioles of heart (increases coronary perfusion)
  • blockade at SA node (reduces heart rate)
  • blockade at AV node (decreases AV nodal conduction)
  • Blockade in the myocardium (decreases force of contraction)
18
Q

what is the most important hemodynamic effect

A

Blockade at AV node

19
Q

Verapamil [Isoptin] therapeutic uses

A
  • angina pectoris (vasospastic and exertional angina)
  • essential hypertension (second line agent)
  • Cardiac dysrhythmias (atrial flutter, atrial fibrillation, paroxysmal supraventricular tachycardia (IV)
  • headaches
20
Q

verapamil [Isoptin] is

A

highly protein bound
- 1st pass metabolism

21
Q

verapamil [Isoptin] adverse effect s

A
  • constipation **
  • Dizziness
  • facial flushing
  • headache
  • edema of ankles and feet
  • Gingival hyperplasia
  • heart block
22
Q

Verapamil [Isoptin] food interaction

A

Grapefruit juice

23
Q

Verapamil [Isoptin] toxcitiy

A
  • severe hypertension
  • bradycardia and AV block
  • ventricular tachydysrhythmias
24
Q

Diltiazem [Cardizem, Tiazac] benefits

A
  • similar to verapamil except less constipation
25
Q

Diltiazem [Cardizem, Tiazac] administration

A

oral preperations often sustained release formulas

26
Q

Diltiazem [Cardizem, Tiazac] is used for

A

hypertension, angina, and cardiac dysrhythmias

27
Q

Nifedipine cannot be used to treat

A

dysrhythmias

28
Q

Nifedipine is less likely than verapamil to exacerbate

A

preexsiting cardiac disorders

29
Q

Nifedipine [Adalat, Adalat XL] theapeutic uses

A
  • angina pectoris
  • hypertension
  • investigational basis: relieve migraine headaches
30
Q

Nifedipine [Adalat, Adalat XL] direct effects

A
  • limited to blockade of Ca channels in vascular smooth muscle
31
Q

Nifedipine [Adalat, Adalat XL] has no direct suppressant effect on

A

automaticity, AV conduction, or contractile forces

32
Q

Nifedipine [Adalat, Adalat XL] indirect effects

A

lowered blood pressure (BP) activates baroreceptor reflex (primarily with immediate release versus sustained release)

33
Q

Nifedipine effects

A
  • lowered blood pressure
  • increased heart rate
  • increased contractile force
34
Q

Nifedipine adverse effects

A
  • flushing
  • dizziness, headache
  • peripheral edema
  • gingival hyperplasia
  • chronic eczematous rash (older patients)
  • increases cardiac oxygen demand
35
Q

Nifedipine can be combined with _____ for prevention of __________

A

beta blocker
reflex tachycardia

36
Q

Nifedipine adverse effects

A
  • increased mortaliy in patients with MI and unstable angina
37
Q

Nursing implications for Nifedipine

A
  • monitor BP, rhythm, HR
  • many are sustained release (do not crush)
  • monitor for constipation, peripheral edema, cardiosupression

HLST220: Pharmacology (46 decks)

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