CAB's selectively inhibit _-type channels. They reduce _________ __ ______ by decreasing _________ and causing coronary ____________.
- myocardial O2 demand
What are the 3 classes of CAB's? name a drug in each.
- PHENYLALKYLAMINES- verapamil
- DIHYDROPYRIDINES- nicardipine
- BENZOTHIAZEPINES- Diltiamzem
name the 6 types of antihypertensives:
- ACE- I
pharmacologic fx of CCB's: (7)
(hint: the first 6 are decreases)
- ↓ contractility, HR, SA node activity, AV Node conduction, systemic BP.
- secondary vasc smooth muscle relaxation.
the clinical fx of CCB's include peripheral ___________ (which decreases afterload), depression of ________ _____________, improving myocardial _______,electrophys conduction (fx= ______________).
- myocardial contractility
Clincal Uses of CCB's.
- coronary artery spasm
- stable angina
- cerebral vasospasm
Verapamil is a derivative of __________. It is in the class _______________, and also works on ____ __ ________ potentiating the fx of _____ __________.
- fast Na channels
- Local anesthetics
- ****Can be injected locally
Verapmil causes depression of what node? is also a negative __________ and ________ and causes vasodilation.
- AV, SA
- chronotrope, inotrope
Verapamil is good for tx of arrythmias _____ the SA node.
What are the clinical uses of verapamil?
- SVT tx
- Stable angina
- essential HTN
- maternal and fetal tachydyrhthmias
- intra-arterial injection for cerebral vasospasm
Nifedipine causes ___________, no _____ depression, reflex __________ and myocardial __________.
What are the clinical uses of Nifedipine?
Angina and HTN emergencies
Why is nifedipine not often used? what are some other facts about it?
- LIGHT SENSitive
- severe hypotension and reflex tachy
- causes edema
no myocardial depression, no conduction fx
Nicardipine causes arterial and venous ___________. It is used for perioperative ___, to improve __ _______ during ischemia, and coronary spasm.
- LV function
Nicardipine dose, half life, infusion rate:
- 1-2ml's (100mcg/ml)
- 14 min
- 5 mg/hr
NIMODIPINE is the ____ ________ analogue of __________. It crosses the ___
- lipid solube
what is the clinical use of NIMODIPINE?
to treat cerebral vasospasm
Diltiazem (cardizem) is a _______________. it effects __ node function and can be used for SVT's including _ ___ and _______. It has minimal myocardial __________ and causes coronary ____________. Can be used to treat _________ HTN.
- a fib, flutter
What drugs can interact with CCB's?
- local anest
- K+ containing solutions
- plt function
- Digoxin (increased plasma concentration)
CCBs can cause increased plasma concentrations of with anti - dysrhythmic?
the "PINES" do what?
CLEVIDIPINE is a 3rd generation _______________ that causes ________ vasodilation, has a ____ onset, a half-life of _ minute, and is cleared by ______ ____________. It looks like what drug?
- plasma cholinesterase
What are 2 reasons why SNP is not often used?
methemoglobinemia and cyanide poisoning