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Calcium Channel Blockers
Terms in this set (25)
what is the effect of Ca on vascular smooth muscle?
regulate contraction: Ca enters and initiates contraction
what is the effect of Ca blockade on vascular smooth muscle?
what is the effect of Ca on the myocardium?
positive ionotropic effect
Ca increases force of contraction
what is the effect of Ca blockade on the myocardium?
decrease contractile force
what is the effect of Ca on the SA node and AV node?
SA node: pacemaker activity
AV node: coordinate contraction of atria and ventricles
increased discharge=increased HR and conduction
what is the effect of Ca blockade on the SA node and AV node?
reduce HR (SA node)
reduce velocity of conduction (AV node)
what is the effect of Ca on the coupling of cardiac Ca channels to beta-1 adrenergic receptors in the heart?
activation of beta1 receptors enhances Ca influx
-block of beta1 Receptors/Ca channels: same effect (reduce force of contraction, slow HR, suppress conduction through the AV node
what do CCBs do?
block Ca entry
where do CCBs have the greatest effect?
what are the 3 classes of CCBs?
where is the site of action of the dihydropyridines?
where is the site of action of the phenylalkylamines and benzothiazepines?
name the phenylalkylamine
Veramapil (Calan, Covera-HS, Isoptin, Verelan)
what is the MOA of Verapamil?
blocks Ca channels in blood vessels and heart
what are the hemodynamic effects of veramapil?
-reduced arterial pressure
-increased coronary perfusion
-SA node (reduce HR)
-AV node (decreased conduction)
-Myocardium (decrease contractile force)
what are the indirect effects (baroreceptor reflex) of Verapamil?
due to lower BP:
-causes sympathetic activity
-effects neutralized (little or no effect on cardiac performance)
what are the therapeutic uses of Verapamil?
-angina pectoris (vasodilation)
-Cardiac dysrhythmias (slows ventricular rate)
-Migraine (investigational use)
does Verapamil have an effect of cardiac performance?
-little to none
*HR, AV conduction, and contractility are not noticeably altered
what are the AE of Verapamil?
-edema of ankles and feet
-heart block (not to be used in 2nd or 3rd AV block)
Name the dihydropyridine
Nifedipine (Adalat CC, Nifediac, Nifedical, Procardia)
what is the MOA of Nifedipine?
vasodilation by blocking Ca channels
what are the direct effects of Nifedipine?
increases coronary perfusion
what is an indirect effect of Nifedipine?
Baroreceptor reflex-increased HR and contractile force
*only in fast acting and not SR formulations
what are the therapeutic uses of Nifedipine?
angina pectoris (combined with beta blocker to prevent reflex cardiac stimulation
-HT (only SR formulation)
-suppress preterm labor (investigational use)
what are the AE of Nifedipine?
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