Category:Calcium channel blockers

From Ganfyd

Introduction

A useful class of smooth muscle relaxants.

History

Clinical Use

Indications

• Hypertension
• Angina
• Verapamil and diltiazem modulate atrial electrical conduction.

Clinical Differences

• Verapamil

While a negatively inotrophic drug, with the combination with beta blockers being problematical it is useful and often well tolerated

• Diltiazem

It is a better choice for atrial rate control than verapramil in atrial fibrillation as it has only weak if any negative inotrophic action, but few seem to know this

Dihydropyridines

None of these are used for rate control.

• Amlodipine
• Felodipine
• Israpidine
• Lacidipine
• Lercanidipine
• Nicardipine
• Nifedipine - In those with ischaemic heart disease as it induces a reflex tacycardia which increases cardiac work it should be used combined with a betablocker.It is however useful as being a liquid, it can be rapidy absorbed (sublingual or mucosal) for most forms of smooth muscle spasm, including prinzmetal angina.
• Nimodipine -specific for treatment to prevent ischaemic cerebral damage after subarachnoid haemorrhage. This is believed to be because it preferentally acts on the smooth muscle of cerebral arteries.
• Nisoldipine

Clinical Issues

Toxicity

Group Contra-indications

Group Cautions and Interactions

Group Side effects

• Constipation
• Oedema

Special advice

Pharmacology