Verapamil (Isoptin, Calan)

Question 1

Verapamil (Isoptin, Calan)

Class

Answer 1

Antiarrhythmic

Question 2

Verapamil (Isoptin, Calan)

Mechanism of Actions

Answer 2

Calcium channel blocker, class IV antiarrhythmic, prolongs AV nodal refractory period, dilates coronary arteries and arterioles, inhibits reentry during PSVT

Question 3

Verapamil (Isoptin, Calan)

Indications

Answer 3

stable narrow complex tachycardias: PSVT, PAT, A-fib, A-flutter with rapid ventricular response.

Question 4

Verapamil (Isoptin, Calan)

Contraindications

Answer 4

W-P-W syndrome, second- and third-degree AV blocks, sick sinus syndrome (unless patient has a functioning pacemaker), hypotension, cardiogenic shock, pulmonary edema, patients receiving IV beta-blockers, wide- complex tachycardia, children less than 12 months of age.

Question 5

Verapamil (Isoptin, Calan)

Adverse Reactions

Answer 5

Hypotension, AV block, bradycardia, Asystole, dizziness, headache, nausea, vomiting, complete AV block, and peripheral edema.

Question 6

Verapamil (Isoptin, Calan)

Drug Interactions

Answer 6

Increases serum concentrations of digoxin. Beta-adrenergic blockers may have additive negative inotropic and chronotropic effects. Antihypertensives may potentiate hypotensive effects.

Question 7

Verapamil (Isoptin, Calan)

Adult Dosage

Answer 7

2.5 – 5.0 mg IV bolus over 2 minutes (over 3 minutes in older patients). Repeat doses of 5 – 10 mg may be given every 15 – 30 minutes to a maximum of 20 mg.

Question 8

Verapamil (Isoptin, Calan)

Pediatric Dosage

Answer 8

0.1 – 0.2 mg/kg/dose IV/IO push over minutes. Repeat dose in 30 minutes if ineffective. Not to be used in patients under 12 months of age.

Question 9

Verapamil (Isoptin, Calan)

Onset

Answer 9

2-5 Minutes

Question 10

Verapamil (Isoptin, Calan)

Peak Effect

Answer 10

Variable

Question 11

Verapamil (Isoptin, Calan)

Duration

Answer 11

30-60 Minutes