CCBs Flashcards

1
Q

How many types of Ca channels are there?

A

4

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2
Q

What are L-channels responsible for?

A

inward movement of Ca into skeletal, cardiac and smooth muscle

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3
Q

What do CCBs treat?

A

angina
hypertension
AF

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4
Q

What do CCBs block?

A

block the flow of Ca ions into heart muscle cells and arteries

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5
Q

Classes of CCBs

A
  • 1,4-Dihydropyridine
  • Benzothiazepines
  • Phenylalkylamines
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6
Q

How do they block Ca ion flow?

A

they bind at specific sites in the open form of the channel

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7
Q

Is there structural similarity between classes?

A

no

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8
Q

Example of a benzothiazepine drug

A

diltiazem

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9
Q

Phenylalkylamine drug

A

verapamil

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10
Q

1,4-Dihydropyridine drug

A

amlodipine

nifedipine

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11
Q

What does each contain?

A

an amine

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12
Q

What does the amine allow for?

A

oral administration

because it can form water soluble hydrochloride salt

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13
Q

Does first pass metabolism take place?

A

yes

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14
Q

What first pass metabolism happens to amlodipine?

A

aromatic hydroxylation

dihydropyridine oxidation

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15
Q

What first pass metabolism happens to verapamil?

A

N and O demethylation

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16
Q

What first pass metabolism happens to diltiazem?

A

hydrolysis

17
Q

Where are 1,4-dihydropyridine Ca channels located?

A

vascular smooth muscle

18
Q

Where are benzothiazepine Ca channels located?

A

cardiac muscle

19
Q

Where are phenylalkylamine Ca channels located?

A

cardiac muscle

20
Q

What 2 CCBs have an synergistic effect?

A

dihydropyridines and benzothiazepines

21
Q

Plasma half life of nifedipine

A

1.5 - 2 hrs

22
Q

What metabolic transformation occurs in nifedipine?

A

oxidation

gives a pyridine, loses 2 Hs

23
Q

What is amlodipine administered as?

A

as a racemate

maleate salt

24
Q

Which isomer of amlodipine is x1000 more active?

25
What reduces activity at N1 on 1,4-dihydropyridine?
substitution
26
What can be added to C 2/6 on dihydropyridine to add to activity?
small groups CH3 CHO CN
27
What decreases activity on C 2/6 on dihydropyridines?
H or Ph
28
What is essential at C4 in dihydropyridine?
phenyl ring
29
What needs to be at C3 on dihydropyridines?
ester group
30
What adds lipophilicity at C5 on duhyfropyridines?
ester
31
How many chiral centers in diltiazem?
2
32
Which from is x10 more active in diltiazem?
cis form
33
What can diltiazem also be prescribes as?
inhibitor of CTP3A4
34
What is verapamil administered as?
a racemate | hydrochloric salt
35
What is the active metabolite of verapamil?
norverapamil