PHARM EXAM 3 > Chapter 48 > Flashcards

Chapter 48 Flashcards

Calcium Channel Blockers (50 cards)

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1
Q

What does calcium normally do?

A

Makes heart beat faster & causes vessels to contract

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2
Q

CALCIUM CHANNEL BLOCKERS
-What are L-type channels necessary for?

A

-the heart to pump & for the heart vessels to contract

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3
Q

CALCIUM CHANNEL BLOCKERS
-What do CCBs do?

A

They BLOCK calcium from entering the heart & blood vessels through the L-type channels

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4
Q

CALCIUM CHANNEL BLOCKERS
-What happens when calcium is blocked?
-What is the end result?

A

-Heart beat slows down, contracts with less force, blood vessels dilate
-It decreases the heart’s O2 demand

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5
Q

CALCIUM CHANNEL BLOCKERS
-What are the two main classes & the medications that correspond?

A
  1. Non-Dihydropyridine (verapamil, diltiazem)
  2. Dihydropyridine (nifedipine)
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6
Q

CALCIUM CHANNEL BLOCKERS
-What do non-dihydripyridines act on?

A

BOTH the heart & blood vessels

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7
Q

CALCIUM CHANNEL BLOCKERS
-What do dihydropyridines act on?

A

PRIMARILY on blood vessels –> minimal cardiac effects

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8
Q

VERAPAMIL
-What is the drug class?

A

Non-dihydropyridines

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9
Q

VERAPAMIL: Therapeutic Uses
-What are the 3 uses?

A
  1. Angina pectoris
  2. Essential HTN
  3. Cardiac dysrhythmias
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10
Q

VERAPAMIL: Therapeutic Uses
-What kind of angina pectoris does this treat?

A

Vasospastic angina & angina of effort

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11
Q

VERAPAMIL: Therapeutic Uses
-Describe how verapamil is related to the treatment of essential HTN

A

It is a second-line agent AFTER thiazide diuretics (CBC are also a second line)

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12
Q

VERAPAMIL: Therapeutic Uses
-In terms of cardiac dysrhythmias, what does this treat? (3)

A
  1. Atrial flutter
  2. Atrial fibrillation
  3. Paroxysmal supraventricular tachycardia
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13
Q

VERAPAMIL: Mechanism of Action
-How does this drug work? (5)

A
  1. Blocks calcium entry
  2. Decreases myocardial contractility
  3. Reduces HR
  4. Decreases AV conduction
  5. Decreases BP
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14
Q

VERAPAMIL: Pharmacokinetics
-What is the route?

A

PO, IV

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15
Q

VERAPAMIL: Pharmacokinetics
-How is it eliminated?

A

In bile

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16
Q

VERAPAMIL
-What are some side effects? (6)

A
  1. Bradycardia
  2. Dizziness
  3. Fatigue
  4. Headache
  5. Hypotension
  6. Peripheral edema
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17
Q

VERAPAMIL: Adverse Effects
-What is the MOST COMMON complain?
-What does this result from?

A

-Constipation
-Blockade of calcium channels in smooth muscle of the intestine

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18
Q

VERAPAMIL: Adverse Effects
-What are the MOST SERIOUS adverse effects? (5)

A
  1. AV block (partial or complete)
  2. Bradycardia
  3. Decreased contractility
  4. HYPOtension
  5. Peripheral edema
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19
Q

VERAPAMIL: Drug & Food Interactions
-What are the 3 drug/food interactions?

A
  1. Digoxin
  2. Beta-adrenergic blocking agents
  3. Grapefruit juice
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20
Q

VERAPAMIL: Drug & Food Interactions
-Who should this be used cautiously in?
-Why?

A

-Patients with HF
-Digoxin increases risk of toxicity

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21
Q

VERAPAMIL: Drug & Food Interactions
-What do beta-adrenergic blocking agents do?

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A

-they suppress HR –> leads to FURTHER bradycardia

22
Q

VERAPAMIL: Drug & Food Interactions
-Why should patients on verapamil NOT drink grapefruit juice?

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A

It increases risk of toxicity

23
Q

VERAPAMIL: Verapamil Toxicity
-What are the s/s? (3)

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A

-AV block & bradycardia (cardiotoxicity)
-SEVERE HYPOTENSION

24
Q

VERAPAMIL: Verapamil Toxicity
-What are 4 things to treat this?

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A

1 & 2. Gastric lavage & activated charcoal –> can be removed through GI tract
3. IV norepinephrine –> vasoconstriction
4. Actropine –> increases HR

25
**VERAPAMIL**: *IV Verapamil* -What is this for? -What can it cause? -What should you do when patients are on IV verapamil?
-Dysrhythmias -Severe cardiovascular effects -Monitor BP & ECG at **ALL** times
26
**VERAPAMIL**: *IV Verapamil* -What should be kept immediately available?
Resuscitation equipment
27
**VERAPAMIL**: *IV Verapamil* -It is okay for patients to be on IV verapamil for long periods of time (T/F)
FALSE!
28
**VERAPAMIL** -Diltiazem?
Same as verapamil!
29
**NIFEDIPINE** -What is the drug class?
Dihydrapyridine
30
**NIFEDIPINE**: *Therapeutic Uses* -What 2 things is this used for?
1. Angina Pectoris 2. HTN
31
**NIFEDIPINE**: *Therapeutic Uses* -Off-label use?
Suppresses preterm labor
32
**NIFEDIPINE**: *Therapeutic Uses* -This can treat dysrhythmias (T/F)
FALSE
33
**NIFEDIPINE**: *Mechanism of Action* -What does this do?
-LOWERS BP -INCREASES HR & contractile force
34
**NIFEDIPINE**: *Pharmacokinetics* -What is the route?
PO
35
**NIFEDIPINE**: *Adverse Effects* -What is the **MOST SERIOUS** adverse effect?
Reflex tachycardia
36
**NIFEDIPINE**: *Adverse Effects* -What is one of the most common adverse effects? -What does it mean?
-Gingival hyperplasia -Gums overgrow on the teeth
37
**NIFEDIPINE**: *Adverse Effects* -What are the 4 other common adverse effects?
1. Dizziness 2. Flushing 3. Headache 4. Peripheral Edema
38
**NIFEDIPINE**: *Adverse Effects* -Does this increase or decrease cardiac oxygen demand?
INCREASE
39
**NIFEDIPINE**: *Adverse Effects* -Patients with angina may experience what? -Why?
-Increased pain -due to increased O2 demand
40
**NIFEDIPINE**: *Adverse Effects* -What can older patients get from nifedipine?
Chronic eczematous rash
41
**NIFEDIPINE**: *Drug Interactions* -What is nifedipine usually combined with? -Why?
-A beta blocker (metoprolol) -To prevent reflex tachycardia
42
**NIFEDIPINE**: *Drug Interactions* -Toxicity?
Same as verapamil --> digoxin & grapefruit juice
43
**NIFEDIPINE**: *Side Note* -We have to keep the _____ in mind -What are they?
-Formulation -Instant release (IR) & sustained release (SR)
44
**NIFEDIPINE**: *Side Note* -What does IR cause? -What does this do?
-a RAPID drop in BP -It activates the baroreceptor reflex, leading to tachycardia
45
**NIFEDIPINE**: *Side Note* -What does SR cause? -What does this mean?
-a GRADUAL drop in BP -it gives you more time to stabilize them
46
**NURSING ASSESSMENT & INTERVENTIONS** -What will you monitor before administering CCBs?
BP & HR (bradycardia)!!
47
**NURSING ASSESSMENT & INTERVENTIONS** -Assess for what things?
Edema or dizziness
48
**NURSING ASSESSMENT & INTERVENTIONS** -What 2 things do you educate the patient on?
Orthostatic hypotension & fall precautions
49
**NURSING ASSESSMENT & INTERVENTIONS** -The patients should report what two things?
Heart palpitations & fainting spells
50
**NURSING ASSESSMENT & INTERVENTIONS** -What should you **NOT** do with extended release (ER) formulations?
DO NOT crush them
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