Calcium Channel Blockers Flashcards
CCB Moa?
Blocks L type calcium channels, subsequently reducing vasoconstriction and cardiac contractility
Name 2 dihydropyridines
Amlodipine and lercanidipine
Name two non-dihydropyridines
Verapamil and diltiazem
Which CCB class is more selective for the peripheral vasculature? Give 2 examples.
Dihydropyridines. Like amlodipine and lercanidipine
Where do diltiazem and verapamil work? Which one is even more selective for this area?
The heart. Verapamil has the greatest effect on contractility and conduction
Amlodipine dose regime?
2.5 - 5mg for 1-2 weeks, then increase to 10mg
When should the dosage of amlodipine be reduced? In hepatic or renal impairment?
Hepatic
Common ADRs of amlodipine and lercanidipine?
Vasodilator effects like flushing, headaches, dizziness, nausea
Compare amlodipine to nifedipine
Nifedipine is shorter acting and needs to be taken twice daily. Also more likely to get reflex cardiac events, like palpitations and angina
Rare side effects of CCBs?
Raised hepatic enzymes (could monitor this)
Orthostatic hypotension, rash, itch
Diltiazem dose?
180-240mg once daily, increased up to 360 if necessary.
This is for hypertension. Lower starting doses are used for AF rate control
Dilatizem and verapamil ADRs?
Bradycardia, and potential for worsened heart failure
Lercanidipine dose?
10mg once daily. Increase to 20 if necessary after 2 weeks j
Side effect unique to verapamil?
Constipation
Contraindications for non-dihydropyridine use?
Severe bradycardia, hypotension or AV block. Should not combine with beta blockers
