Calcium-channel blockers: Nursing Pharmacology

Notes

CALCIUM-CHANNEL BLOCKERS
DRUG NAME	Dihydropyridines: nifedipine (Procardia, Adalat), amlodipine (Norvasc), clevidipine (Cleviprex), nicardipine (Cardene), felodipine (Plendil), nimodipine (Nimotop) Non-dihydropyridines: diltiazem (Cardizem), verapamil (Calan, Isoptin)
CLASS	Calcium Channel Blockers (CCB)
MECHANISM OF ACTION	Block the entry of calcium into the cells Reduce the contraction of vascular smooth muscle and cardiac muscle Dilate arterioles, and reduce blood pressure and peripheral vascular resistance Dilate coronary vessels and increase oxygen supply to the heart Reduce force of contraction of cardiac muscles and reduce oxygen demand of the heart Reduce the firing and conduction of impulse through the SA and AV nodes in the heart
INDICATIONS	Cardiac arrhythmia, hypertension, angina pectoris, tocolysis in preterm labor, Raynaud’s phenomenon, migraine prophylaxis Nimodipine: subarachnoid hemorrhage
ROUTE(S) OF ADMINISTRATION	PO IV
SIDE EFFECTS	General: headache, dizziness, flushing of the skin, peripheral edema, hypotension Dihydropyridines: reflex tachycardia, gingival hyperplasia Non-dihydropyridines: bradycardia, constipation and hyperprolactinemia
CONTRAINDICATIONS AND CAUTIONS	Pre-existing bradycardia Heart block Heart failure Use with caution: hepatic and renal disease Interactions: digoxin, grapefruit

NURSING CONSIDERATIONS: CALCIUM-CHANNEL BLOCKERS
ASSESSMENT AND MONITORING	Vital signs, CBC, sodium, potassium, creatinine, BUN, liver function tests, and urinalysis, ECG For angina: frequency and severity of symptoms Monitor for side effects and therapeutic response
CLIENT EDUCATION	Purpose of medication Self-administration Take exactly as prescribed, do not stop abruptly Swallow whole; do not divide, crush, or chew Avoid grapefruit juice and limit caffeine Side effects Hypotension and reflex tachycardia: change positions slowly Peripheral edema: elevate legs Constipation: increase fiber and fluids Gingival hyperplasia: good dental hygiene Lifestyle modifications for cardiovascular health Heart rate and blood pressure self-monitoring Report persistent side effects, hypotension, bradycardia; seek medical attention if angina not relieved by rest or medication

Memory Anchors and Partner Content

Sources

"Focus on Nursing Pharmacology" LWW (2019)
"Pharmacology - A Patient-Centered Nursing Process Approach (8e)" Elsevier Health Sciences (2014)
"Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2020)
"Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2018)
"First Aid for the USMLE Step 1 2018, 28th Edition" McGraw-Hill Education / Medical (2018)
"Rang and Dale's Pharmacology" Elsevier (2018)
"Basic & Clinical Pharmacology (15e)" McGraw Hill (2021)
"Calcium Channel Blockers" StatPearls [Internet] (2021)
"Calcium Channel Blocker" Wikipedia ()
"Mosby's 2021 Nursing Drug Reference" Mosby (2021)

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