DIILTIAZEM

Question 1

Drug class

Answer 1

calcium channel blocker

Question 2

How does it work? (4)

Answer 2

• deceases Ca entry into the vascular and cardiac cells
• this reduces intracellular calcium concentration
• consequently causing relaxation and vasodilation in arterial smooth muscle
• this consequently lowers arterial pressure

Question 3

How does diltiazem reduce myocardial contractibility and reducing angina? (4)

Answer 3

• suppress cardiac conduction across the AV node
• reducing heart rate and contractility and after load
• reducing myocardial oxygen demand
• consequently reducing angina

Question 4

Indications (3)

Answer 4

1. hypertension
2. stable angina
3. supraventricular arrhythmias - controls rate

Question 5

Contra-indications (1 (2))

Answer 5

1. heart
   - can make heart failure worse - by causing poor left ventricular function
   - complete heart block - AV node delay

Question 6

Side effects (4)

Answer 6

1. feet
   - ankle swelling
2. Face and head
   - flushing
   - headache
3. heart (x4)
   - palpitations
   - bradycardia
   - heart block
   - heart failure
4. GI
   - constipation

Question 7

Interactions (1)

Answer 7

1. beta blockers

• both are negatively ionotrophic and chronotrophic
• this can cause heart failure, bradycardia and asystole

Question 8

Elimination (2)

Answer 8

• faeces - mainly

- bile