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21 Cards in this Set
- Front
- Back
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Name the most important non-dihydropyridine calcium channel blockers |
Verapimil and diltiazem |
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Indications of verapamil and diltiazem? |
Angina pectoris, supraventricular tachycardias, hypertrophic cardiomyopathy and hypertension. |
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Mechanism of action of verapamil and diltiazem? |
These drugs inhibit calcium channels in vascular smooth muscle and cardiac muscle. This vasodilates the coronaries and causes negative heart effects, which decreases the oxygen demand of the myocardium. |
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What can be a side effect of the fast-acting DHPs? |
They may activate the baroreflex, which induces increased sympathetic tone and tachycardia. |
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In which conditions is verapamil and diltiazem contraindicated? |
Bradycardia, sick sinus syndrome, AV-block and hypotension, heart failure Liver disease due to extensive first pass effect. |
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Interactions of verapamil and dialtiazem? |
Verapamil decreases excretion of digotoxin, they should not be given together. Should not be combined with beta blockers or digitalis due to negative heart effects. |
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Side effects of verapamil?
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Constipation, negative heart effects |
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Indications of dihydropyridines? |
Hypertension, angina pectoris and vasospastic disease (Reynauds disease and acrocyanosis), hypertensive emergencies |
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Contraindications of dihydropyridines? |
Unstable angina and AMI due to the reflex tachycardia which may suddenly increase the O2-demand of the myocardium. This can especially happen with Nifedipine. |
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How long does the short-and-rapidly acting DHPs work? |
Half-life of 4-6 hours. Work immediately. Provoke strong baroreflex effect. |
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Name short-and-rapidly acting DHPs. |
Nifedipine, nimodipine, nicardipine. |
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Indications of Nifedipine? |
Can be given as chewing tablet or oral spray for hypertensive emergencies. - migraine prophylaxis - Reynolds phenomenon. |
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Indications of nimodipine? |
Used to treat cerebral vasospasm after subarachnoid bleeding. Only type which can be given IV. |
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Indications of Nicardipine? |
Prinzmetals angina - effective in coronary arteries. |
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Name some intermediate-acting DHPs. |
Nitredipine, isradipine and nisoldipine. They have half-life of 8-11 hours. |
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What is the unique effect of isradipine? |
Can lower LDL and VDLD while increasing HDL, giving a antiatherogenic effect. |
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Name slowly and long acting DHPs. |
Amlodipine and lacidipine. |
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How can we prevent reflex tachycardia with dihydropyridines? |
By using depot formulations or giving beta blockers. |
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Side effects of dihydropyridines? |
- Peripheral oedema - Flushing - Gingival hyperplasia |
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Mechanism of action behind the cardiac effects of verapimil and diltiazem? |
They prevent calcium from entering through L-type channels in the SA-node, AV-node and myocardial fibres, which cause negative heart effects. |
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Which negative heart effects do verapamil and diltiazem cause? |
- Decreased heart rate - Decreased contractility - Decreased conduction velocity . Decreased excitability |
