Friday, February 20, 2015

Study group discussion: Calcium channel blockers

Which calcium channel blockers are not given in CHF?

Verapamil

Diltiazem

Correct. And why?

Decrease contractility.

Correct. They are negative dromotropic and negative ionotropic.

So in which conditions do you give verapamil and diltiazim?

Hypertension?

It's not hypertension. For hypertension you use dipines.

CCB are class 4 antiarrhythmics. So they are used in arrhythmias of atrial origin.

Remember.. The dipines act predominantly on vessels.. Hence they are preferred in hypertension.

Verapamil and diltiazem on the other hand act equally on heart as well as vessels.

Unstable angina?

They are used in unstable angina correct!

Which type of calcium channels do CCB act?

L type

First choice drug in hypertensive crisis?

Na nitropruside

Correct Priyanka

Now tell me why?

Marked fall in BP in a few mins.

There is one more reason.

Equal arterial as well as venous dilator!

Brilliant!

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