Calcium channel blockers





Introduction

Calcium channel blockers are primarily used in the management of cardiovascular disease. Voltage-gated calcium channels are present in myocardial cells, cells of the conduction system and those of the vascular smooth muscle. The various types of calcium channel blockers have varying effects on these three areas and it is therefore important to differentiate their uses and actions.


ExamplesIndications & notes
VerapamilAngina, hypertension, arrhythmias
DiltiazemAngina, hypertension
Nifedipine, amlodipine, felodipine
(dihydropyridines)
Flushing, headache, ankle swelling

Adverse effects

ExamplesSide-effects and cautions
Verapamil
Highly negatively inotropic. Should not be given with beta-blockers as may cause heart block

Heart failure, constipation, hypotension, bradycardia, flushing
Diltiazem
Less negatively inotropic than verapamil but caution should still be exercised when patients have heart failure or are taking beta-blockers

Hypotension, bradycardia, heart failure, ankle swelling
Nifedipine, amlodipine, felodipine
(dihydropyridines)
Flushing, headache, ankle swelling