CCB Flashcards
Non dihydro pyradine Ca blocker examples
VERADIMIL
DILTIAZEM
NDPCB mechanism ( primarily acts on cardiac muscle)
block Ca from entreating pacemaker cells , AP reduces and so less AP sent to non pacemaker cells through gap junction.
Thus non pacemaker cells can’t have Ca for muscle contraction
Therefore Heart Rate REDUCED
Dihydro pyradine Ca blockers ( DPCB) examples
AMLODIPINE
NICARDIPINE
NIMODIPINE
NIFEDIPINE
DPCB mechanism
Less Ca enters the smooth muscle cells of tunica media and so less CAM-Kinase therefore less phosphorylation of MLCK to P-MLCK and less phosphorylation of myosin.
Therefore less muscle contraction and VASODILATION OCCURS
NDPCB use
Inhibit SA node so HR is reduced
Blocks AV mode conduction - good for arrhythmia
Can lead to less contractility
DPCB use
abbey effects peripheral vasculature , arterial smooth muscle and promotes vasodilation.
TPR reduces so BP reduces
GOOD ANTI HTN
2 classes of CCB
- NDPCB - Non dihydro pyradine Ca blockers
2. DPCB - dihyro pyradine Ca blockers
Indications of CCB
A-FIB A-Flutter Premature atrial contractions Heart failure ( O2 demand reduced) Angina ( when BB can’t be given ) HTN
Good CCB in pregnancy
NIFEDIPINE
HTN emergency CCB
NICOCARDIPINE
Side effects of CCB
Bradycardia ( maybe heart blocks)
Hypo TN
Reflex Tachycardia
Edema in lower extremities as (capillary permeability increases )
Flushing
Orthostatic HypoTN
SPECIAL:
THICKENING OF GINGIVA (Amoldipine)
Constipation
Hyperprolactenemia ( veradimil)
VERADIMIL side effects
Hyperlactinemia ,
gynecomastia in M
Glactorrhea and menstrual irregularity in F
Contraindications of CCB
Decompensated HF
Weak heart
Aortic valve stenosis
HypoTN crisis
VERADIMIL side effect mechanism
it inhibits dopamine production therefore Prolactin increases
