Calcium Channel Blocker Flashcards by sade blackwood

what is the brand name for amlodipine?

Norvasc

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what class are the following medications:
amlodipine
felodipine
nifedipine
verapamil

calcium channel blockers

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amlodipine dosage forms?

tablet: 2.5 mg, 5mg, 10mg

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amlodipine indications?

HTN and angina:

HTN: Children 6-17 y of age, 2.5-5 mg po daily; Adults, 5-10 mg po daily

Stable angina: 5-10 mg po daily

Variant angina: 5-10 mg po daily

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Amlodipine MOA?

long-acting dihydropyridine calcium-channel-blocking drug with potent arterial and coronary vasodilating properties

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Amlodipine contraindication?

hypersensitivity to amlodipine

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Amlodipine ADR?

Common: peripheral edema and pulmonary edema

Less common: Abdominal pain, arthralgia, constipation, dizziness, fatigue, flushing, headache, hypotension, hyperkalemia, impotence, myalgia, nausea, palpitations, pruritus, rash, tachycardia, urticaria

Serious: Hepatotoxicity, thrombocytopenia, AMI, angina

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Efficacy Monitoring Parameters for Amlodipine?

Decreased BP, reduction in chest pain, decreased number of weekly angina attacks, reduction in use prophylactic nitroglycerin to relieve chest pain, improvement in signs/symptoms of heart failure

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Amlodipine Key counseling?

Instruct patient to report signs/symptoms of hypotension or exacerbation of angina with initial dosing and dose changes.

Avoid alcohol while taking drug.

Report signs/symptoms of peripheral edema, fatigue, hypotension, or hepatic dysfunction. This medicine may cause dizziness.

Avoid activities that could be dangerous if dizziness occurs at initiation of therapy.

Dizziness may be worse if too much water is lost from the body due to excessive sweating, diarrhea, or vomiting.

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Diltiazem— Brand name?

Cardizem, Cartia XT, Dilacor XR, Dilt-XR, Taztia XT, Tiazac

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Diltiazem Dosage form?

Oral tablet: 30mg, 60mg, 90mg, 120mg
Oral tablet ER: 120mg, 180mg, 240mg, 300mg, 360mg, 420mg
Oral capsule ER 12hr: 60mg, 90mg, 120mg
Oral capsule ER 24hr: 120mg, 180mg, 240mg, 300mg, 360mg, 420mg

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Diltiazem Indication?

HTN: 60-120 mg (extended release, 12 h) po bid, may titrate to 360 mg/d po; 120-240 mg (extended release, 24 h) po daily, may titrate to 540 mg po daily

Stable, chronic angina: 30 mg (immediate release) po qid, may titrate to 360 mg/d po; 120 mg (extended release, 24 h) po daily, may titrate to 540 mg/d po

Atrial arrhythmia and paroxysmal supraventricular tachycardia: 180-360 mg po daily (frequency of dosing based on formulation)
Off-Label Uses.

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Diltiazem Contraindication

Hypersensitivity to diltiazem, hypotension, 2nd/3rd degree AV block, sick sinus syndrome

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diltiazem efficacy monitoring parameters?

Decreased BP, reduction in chest pain, decreased number of angina attacks, reduction in use of nitroglycerin for chest pain

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Diltiazem counseling points?

Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope.

This drug is available in multiple brand names with varying properties by brand. Instruct patient to follow administration instructions specific to the prescribed brand with regards to meals and timing.
Do not drink alcohol while taking this drug.

Some products may be opened and sprinkled on a spoonful of applesauce (applesauce should not be hot, and should be swallowed without chewing, followed by a glass of water).

Administer at same time of day, either morning or evening.

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Felodipine —- Brand Name and class?

Brand name: Plendil

Class: calcium channel blocker and dihydropyridine

Felodipine—- dosage form?

Oral tablet, ER

Felodipine—- Indication?

HTN: 2.5-5 mg po once daily, may increase to 10 mg po once daily

Felodipine—–MOA?

dihydropyridine calcium-channel-blocking drug with potent arterial and coronary vasodilating properties.

A reflex increase in sympathetic tone (in response to vasodilation) counteracts the direct depressant effects on SA and AV nodal conduction. This renders felodipine ineffective in the treatment of supraventricular tachycardias

Felodipine—- Contraindiction?

hypersensitivity to felodipine

Felodipine —— ADR?

Common: Headache, peripheral edema

Less common: Abdominal pain, arthralgia, constipation, dizziness, fatigue, flushing, hypotension, hyperkalemia, impotence, myalgia, nausea, palpitations, pruritus, rash, tachycardia, urticaria

Serious: Hepatotoxicity, thrombocytopenia

Felodipine—– Efficacy monitoring parameters?

Decreased BP, reduction in chest pain, decreased number of weekly angina attacks, reduction in use of prophylactic nitroglycerin to relieve chest pain

Felodipine —-Key counseling points?

Report signs/symptoms of hypotension or exacerbation of angina with initial dosing and dose changes; report signs/symptoms of peripheral edema, fatigue, hypotension, or hepatic dysfunction.

Take at the same time each day.

Avoid excessive grapefruit and grapefruit juice.

Do not discontinue drug abruptly as this may cause rebound HTN.

This medicine may cause dizziness.

Avoid driving, using machinery, or doing anything else that could be dangerous if not alert.

Dizziness may be worse if too much water is lost from the body due to excessive sweating, diarrhea, or vomiting.

Nifedipine—- Brand name and class?

Adalat CC, Procardia XL

Dihydropyridine calcium channel blocker

Nifedipine---- dosage form?

oral tablet ER 24h: 30mg, 60mg, 90mg | oral capsule: 10mg, 20mg

Nifedipine--- indications?

HTN: Adults, extended release, 30 mg po daily, may titrate to 90 mg/d po (Adalat CC) or 120 mg/d po (Procardia XL); Children, 0.25 mg/kg po daily in 1 or 2 divided doses, may titrate to 3 mg/kg/d po (max 180 mg/d) Stable chronic angina: Immediate release, 10-20 mg po tid, may titrate to 20-30 mg po 3-4 times/d, max 160 mg/d; extended release, 30-60 mg po daily, may titrate to 120 mg/d po Variant angina: Immediate release, 5-20 mg pot id; extended release, 30-60 mg po daily, may titrate to 120 mg/d po

Nifedipine--- MOA?

Nifedipine is a calcium ion influx inhibitor that selectively inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle. Nifedipine does not alter serum calcium concentrations.

Nifedipine-- contraindications?

Hypersensitivity, cardiogenic shock, STEMI, concomitant use of CYP3A4/5 inducers

Nifedipine ----- efficacy monitoring parameters?

BP, reduction in chest pain, decreased angina attacks, reduction is usage of nitroglycerin to relieve chest pain

Nifedipine ---- counseling points?

Take Adalat CC on an empty stomach. Report signs/symptoms of hypotension, exacerbation of angina, peripheral edema, fatigue, or hypotension. Avoid sudden discontinuation of drug as this may cause rebound HTN. May cause dizziness; avoid driving or using hazardous machinery until effects are known. Avoid grapefruit juice. May see tablet or shell of dosage form in stool.

Nifedipine----- ADR?

Common: flushing, headache, dizziness, weakness, nausea, dypepsia Less common: muscle cramps, edema, nervousness, palpitation, dyspnea, constipation serious: aplastic anemia , thrombocytopenia, angina, AMI

Verapamil ---- Brand and class?

Calan SR and Calan Calcium channel blocker

Verapamil dosage form?

oral tablet oral tablet ER oral capsule ER 24h

Verapamil ----- indications?

Angina: Immediate release, 80-120 mg po tid; extended release, 180 mg po daily hs, may titrate to 480 mg po daily Atrial arrhythmia or paroxysmal supraventricular tachycardia prophylaxis: Immediate release, 240-320 mg/d in 3-4 divided doses, may titrate to 480 mg/d in nondigitalized patients HTN: Immediate release, 80 mg po tid, may titrate to 360-480 mg/d; extended release, 180-200 mg po daily hs, may titrate to 400-480 mg po daily; extended release, 180 mg po daily in AM, may titrate to 240-480 mg/d

Verapamil ---- Containdication?

Hypersensitivity to verapamil; symptomatic hypotension (systolic BP <90 mm Hg); 2nd- or 3rd-degree AV heart block, sick sinus syndrome; severe left ventricular dysfunction (ejection fraction <30%), atrial fibrillation/flutter associated with accessory bypass tract

Verapamil-- ADR?

Common: ginival hyperplasia Less common: Bradyarrhythmia, constipation, dizziness, fatigue, headache, hypotension, indigestion, nausea, palpitations, peripheral edema, rash, syncope, elevated liver enzymes Serious: Congestive heart failure, heart block, hepatotoxicity, pulmonary edema

Verapamil-- Efficacy monitoring parameters

Decreased BP, improvement in HR and rhythm, reduction in chest pain, decreased number of weekly angina attacks, reduction in use of nitroglycerin for chest pain.

Verapamil ------ counseling points?

Do not crush or chew extended-release products. Contents of extended-release capsules may be sprinkled on food and swallowed without chewing, followed by water. Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope. Avoid sudden discontinuation of drug, as this may precipitate hypertensive rebound/crisis. Rise slowly from a sitting or lying position to avoid dizziness. Avoid alcohol and grapefruit juice.