Pharmacology - Calcium Channel Blockers Flashcards
2 classes of calcium channel blockers
dihydropyridine and non-dihydropyridine
how can non-dihydropyridine calcium channel blockers be further divided?
phenylalkylamine (verapamil)
benzothiazepine (diltiazem)
**true or false
amlodipine is a non-dihydropyridine calcium channel blocker
FALSE
dihydropyridine
anothing that ends in “pine” is a dihydropyridine
**true or false
diltiazem is a phenylalkylamine non-dihydropyridine
FALSE
benzothiazepine non-dihydropyridine
**differentiate between the MOA of dihydropyridines and non-dihydropyridines
dihydro - VASODILATION
non-dihydro - DEPRESS SA AND AV NODE OF THE HEART
MOA of calcium channel blockers in hypertension
inhibit the influx of calcium into arterial smooth muscle
true or false
verapamil, diltiazem, and the dihydropyridines are all equally effective in lowering BP
TRUE
*****which calcium channel blocker is given IV
clevidipine (dihydropyridine)
calcium is involved with BP on a contractile, electrical, and cellular level
explain
contractile - myosin binding - muscle contraction
electrical - calcium gets into SA node and causes increased heart rate
cellular - release of hormones like ACh, NE
**calcium channel blockers mainly target _____ type channel
L-TYPE channel
this causes cmooth muscle relaxation and negative ionotropic effecits in heart
true or false
dihydropyridines have higher vasodilation activity than non
true
true or false
non-dihydropyridines alter calcium mediated pacemaker activity
TRUE
to depress the heart rate and AV node conduction
true or false
dihydropyridines increase peripheral resistance
FALSE
decreases peripheral resistance by causing vasodilation
___ are considered pacemaker blockers
non-dihydropyridines
which type of calcium channel blocker has LESS effect on heart function
dihydropyridines - more involed wiht vasodilation
**which type of calcium channel blockers have a danger of vascular shock? explain why
dihydropyridines
if too much vasodilation - not enough BP
****which type of calcium channel blocker has a liability of bradycardia, and AV block and cardiac arrest
non-dihydropyridines
(verapamil, diltiazem)
which calcium channel blocker can cause reflex tachycardia and paradoxical angina?
nifedipine
2 rare but serious AE of amlodipine
abnormal EKG
ventricular arrythmias
some amlodipine precautions
can initially cause hypotension and lead to fainting
edema
can cause reflex tachycardia and induce angina and heart attack
there is a DDI with amlodipine and CYP ___ inducers/inhibitors
3a4
(watch the grapefruit too!)
true or false
in addition to reducing the heart rate, diltiazem also decreases peripheral resistance and afterload by dilating the systemic arteries
true
true or false
varapamil has negative inotropic effects
true
verapamil inhibits _____ reflexes that elevate BP
sympathetic
which nondihydropyridine is considered an intermediate vasodilator and pacemaker suppressor?
which is considered an EXTREME pacemaker suppressor and vasodilator?
intermediate - diltiazem
extreme - verapami
true or false
nifedipine has low vascular shock liability
FALSE - high
it has high vasodilation activity
true or false
nifedipine has a low risk of AV block and cardiac arrest
TRUE
verapamil is most high risk (then diltiazem)
is clevidipine a dihydropyridine?
yes
true or false
clevidipine has little impact on the contractility of the heart
true
can calcium channel blockers be given in pregnancy
yes
some calcium channel blocker contraindications
heart failure
unstable angina
true or false
calcium channel blockers are not first line for HTN
true
ACE and ARBS are considered 1st line
HOWEVER, it’s been used as 1st line bc high tolerability and efficacy
which type of antihypertensive is preferred in the elderly and prevents stroke?
calcium channel blockers
