ischemia4 Flashcards
patients with coronary artery disease should avoid what
IR nifedipine
only IR CCB
nondihydropyridines can exacerbate what
HF by depressing cardiac function
diltiazem is contraindicated with what?
pulmonary congestion (acute MI risk)
verapamil is contraindicated with what (other than digoxin)?
why?
IV beta-blockers
drastic decrease in HR
why is verapamil contraindicated with digoxin
verapamil inhibits p-glycoprotein; increasing digoxin levels
what are the therapeutic uses of CCB’s (we need to know 4)?
HAVE
Hypertension
Arrhythmia
Variant angina
Exercise induced angina
what CCB is used for migraine prophylaxis?
verapamil
what CCB is used for neuro deficits after aneurysm
nimodipine
what CCB is used for Raynauds disease
Felodipine
Amlodipine
Nifedipine
Diltiazem
what is the positive effect of CCB’s for exercise induced angina treatment?
decrease oxygen demand
increase blood flow
what is first line for MI?
beta blocker
what is the benzothiazepine CCB
diltiazem
what is verapamil’s structural class
diphenylalkylamine
what is diltiazems structural class
benzothiazepine
name two non racemic mixture CCB’s
nifedipine and diltiazem
why do all the CCB’s have pretty low oral bioabailability
extensive 1st pass metabolism
why is amlodipine a preferred CCB
it has a long half life; less reflex tachycardia
what dihydropyridine is IV only?
clevidipine
what is clevidipine’s half life
2 minutes
name a diphenylalkylamine
verapamil
what dihydropyridine is used for it’s neurological effects; helps ease deficits after brain injury
(not used for HTN)
nimodipine
what are CCB’s main effect?
what individual beneficial effects does this have on the heart
arteriole dilation:
increases vasodilation
decreases afterload
decreases oxygen demand
