Non-DHP Calcium Channel Blockers

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Summary

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Key Points

  • Key Drugs
    • Diltiazem
    • Verapamil
    • Mechanism
      • Myocardium selective
      • Decrease contractility
        • Blocks calcium channels in the myocardium, decreasing the strength of cardiac muscle contraction and thus decreasing the oxygen demand of the heart.
      • Decrease heart rate
        • Blocks calcium channels within the SA and AV nodes, slowing the rate of conduction and decreasing the heart rate.
    • Clinical Use
      • Dysrhythmias
        • Supraventricular Tachycardia (SVT)
        • Atrial fibrillation
          • Does not convert atrial fibrillation to sinus rhythm, but can help control ventricular rate.
      • Angina
      • Hypertension
    • Side Effects and Adverse Reactions
      • Bradycardia
        • A suppression of cardiac activity can cause bradycardia, as well as heart block and heart failure.
          • Contraindicated in patients with current bradycardia or heart blocks.
        • Check pulse prior to administration
        • Can result in hypotension
      • Avoid grapefruit juice
        • Increases the amount of drug levels in the body by inhibiting liver enzymes responsible for drug breakdown
        • Can lead to severe cardiac depression
      • Constipation
        • Encourage a high fiber diet