Ch. 44 Calcium Channel Blockers

Front 1

What are CCB's commonly use to treat?

Back 1

hypertension, angina pectoris, and cardiac dysrhythmias

Front 2

What anatomical part of the body CCB's effect the most?

Back 2

the heart and blood vessels

Front 3

What drugs are commonly used to get the effects of CCB's that act on vascular smooth muscle and the heart?

Back 3

i. Verapamil (Calan)
ii. Diltiazem (Cardizem)

Front 4

What drugs are commonly used to get the effects of CCB's that act only on vascular smooth muscle?

Back 4

i. Nifedipine (Procardia)
ii. Other Dihydropyridines

Front 5

What are the three chemical families that CCB's belong to in the United States?

Which is the prototype?

Back 5

The largest family is the dihydropyridines, for which nifedipine is the prototype. This family name is encountered frequently and hence is worth remembering.

The other two families consist of orphans: verapamil is the only phenylalkylamine, and diltiazem is the only benzothiazepine.

Front 6

At high doses nifedipine and the other dihydropyridines act primarily on what?

in contrast, verapamil and diltiazem act on what?

Back 6

ventricular smooth muscle (VSM);

VSM and on the heart.

Front 7

blockade of calcium channels causes effect aterial pressure in what way?

coronary perfusion?
heart rate?
AV conduction?
myocardial contraction?

Back 7

reduction in arterial pressure, increased coronary perfusion, reduction in heart rate, decreased AV conduction, and decreased force of myocardial contraction.

notice perfusion is the only measure that increases.

Front 8

All CCBs promote________ and hence are useful in hypertension and angina pectoris.

Back 8

vasodilation

Front 9

• Because they suppress AV conduction, verapamil and diltiazem are useful for treating cardiac ________ (in addition to _______and ________).

Back 9

dysrhythmias

hypertension and angina pectoris

Front 10

Due to Verapimil and Diltiazem's cardiosuppressant effects what doe AE need to be carefuly monitored for?

Back 10

bradycardia, partial or complete AV block, and exacerbation of heart failure.

Verapamil and Diltiazem are also antihypertensive medications, therefore, blood pressure needs to be monitored with these drugs as well.

In toxic doses dihydropyridines can also cause cardiosupression.

Front 11

What is the most common complaint of patients taking Verapamil?

What are some other common complaints?

Back 11

constipation

dizziness, facial flushing, headache, and edema of the ankles and feet—occur secondary to vasodilation.

Front 12

What affect does Verapamil have on Digoxin?

Back 12

Verapamil increases plasma levels of digoxin by approximately 60%, thereby increasing the risk of digoxin toxicity. Therefore, Dig levels need to be monitored when a patient is being treated with both of these drugs.

Front 13

What affect does Digoxin have on the AV node?

Back 13

further supresses the strength of the impulse conduction through the AV node.

Front 14

Beta Blockers and Verapamil or Diltiazem will ________ cardiosupression.

Back 14

intensify

Front 15

What is Nifedipine (a dihydropyridine) indicated for and what disease is it commonly used to treat for?

Back 15

angina and angina of effort

essential hypertension

Front 16

Unlike Verapamil, Nifedipine _______ is not one of its side effects. However it shares the rest of them for the most part.

Additionally Nifedipene a ______ _____ rash in older patients

Back 16

constipation

(Because they cause vasodilation, all CCBs can cause dizziness, headache, and peripheral edema.)

eczematous rash

Front 17

_______ ________ can be used to suppress reflex tachycardia caused by nifedipine (Procardia) and other dihydropyridines

Back 17

Beta Blockers

Front 18

It is recommended that rapid-acting ________, especially in higher doses, be used with great caution, if at all.

Back 18

nifedipine