CCB ppt Flashcards Preview

Anesthesia Pharm II > CCB ppt > Flashcards

Flashcards in CCB ppt Deck (47)
Loading flashcards...
1

what is the role of intracellular Ca++

regulates contraction

2

how can you tell a myocyte cell from the rest?

it has troponin c

3

how does Ca++ work in cardiac muscle

Ca++ binds to troponinC releives troponin I inhibition of actin-myocin interaction

4

how does Ca++ work in smooth muscle

binds to calmodulin causing actin and myosin interaction

5

where is most Ca++ at intracellular or extracellular?

extracellular

6

where is most of the Ca++ at intracellularly

the SR

7

Ca++ bound to SR is what

inactive

8

Free Ca++ inctracellular concentration is markedly increased when?

during contraction b/c SR releases Ca++ and the Ca++ channel is open allowing Ca++ in

9

what are the 6 types of Ca++ channels

L
N
P
Q
R
T

10

****************
What are the Ca++ channels we deal with ?

L
and
T

11

what type of channels are Ca++ channels

voltage gate

12

what is a voltage gated channel

when they reach a voltage then the open
(a ligand gated is a drug or hormone binding)

13

*****
what is the L-type channel

sustained conductance, slow inactivation

14

****
What is T-type channels

similar to L but rapid inactivation'have minimal sensitivity to CCB

15

**********
with CCB what type of channel are me using the most

L-type

16

5 subunits of L-type (slow) Ca++ channels

alpha 1
alpha 2
beta
gamma
delta

17

*********************************************
3 main types of CCB then what are the real way to differentiate them into 2 goups?

Non-dihydropyridines
-Phenylalkylamines-
-Benzothiazepines-
1,4- dihydropyridines (DHPs)

18

******
so basically all CCB are DHP except for what 2 drugs?

verapamil
and
diltiazem

19

********************
what is an example of a NonDHP phenylaklylamine and benzothiazepines

phenylaklylamine- verapamil
benzothiazepines- diltiazem
a way to try and remember
(benz=lorazepam sounds like diltazem)

20

***********************
what is the main difference b/t NonDHP and DHP?

Non-DHP-affect nodes (both verap and diltaz)
DHP-do not effect Nodes

21

************************
how do phenylalkylamines work?

Verapamil
binds to intracellular portion of alpha subunit 1

22

**********************
how do benzothiazepines work

diltiazem
MOA not understood

23

****************
how do DHP work

modulate the L-type channel
vascular smooth muscle

24

*****************************************
should someone be on cardizen and a BB?

no b/c they both affects nodes

25

*****************************
can someone be on a BB and DHP CCB

sure the DHP CCB don't effect HR

26

********************************
out of the drugs
Verapamil Non-DHP (phenylalkylamine)
Diltiazem Non-DHP (benzothiazepine)
Nifidipine DHP
Nicardipine DHP
which ones in order cause coronary vasodilation

Verapamil- moderate
Diltiazem - mod
Nifidipine - marked
Nicardipine **** greatest

27

*********************
out of the drugs
Verapamil Non-DHP (phenylalkylamine)
Diltiazem Non-DHP (benzothiazepine)
Nifidipine DHP
Nicardipine DHP
whcih ones in order cause supression of cardiac contractility

Verapamil-moderate
Diltiazem -mod
Nifidipine - mod
Nicardipine -0/slight

28

******************
out of the drugs
Verapamil Non-DHP (phenylalkylamine)
Diltiazem Non-DHP (benzothiazepine)
Nifidipine DHP
Nicardipine DHP
which ones in order cause supression of SA node

Verapamil -mod
Diltiazem - slight
Nifidipine - none
Nicardipine - none

29

************
out of the drugs
Verapamil Non-DHP (phenylalkylamine)
Diltiazem Non-DHP (benzothiazepine)
Nifidipine DHP
Nicardipine DHP
which ones in order cause supression of AV node

Verapamil - marked
Diltiazem - mod
Nifidipine - none
Nicardipine - none

30

***********
ex of DHP CCB

Nicardipine
nifedipine
nimodipine
clevidipine
amlodipine
(-pine)
(remember Ca++le graze in the -pine)