immediate release – 立即释放
sustained release – 持续释放
controlled release – 控制释放
amlodipine – n. 氨氯地平
Norvasc – n. 络活喜
felodipine – n. 非洛地平
Plendil – n. 波依定
isradipine – n. 伊拉地平
nicardipine – n. 尼卡地平
Cardene – n. 卡地尼
extended release – 延长释放
diltiazem – n. 地尔硫卓
Cardizem CD – n. 合心爽CD
nifedipine – n. 硝苯地平
Procardia XL – n. 心痛定XL
nisoldipine – n. 尼索地平
Sular – n. 【奥】苏拉尔
verapamil – n. 维拉帕米
Calan SR – n. 卡兰SR
clevidipine – n. 氯维地平
Cleviprex – n. 丁酸氯维地平
action potential – 动作电位 注：带“【奥】”标记者为奥医临时用名，只为方便学员复习记忆，不得作为临床诊疗依据！
—————— ISPN/RN Review ——————
Calcium-Channel Blockers
钙通道阻滞剂
Calcium-channel blockers decrease BP, cardiac workload, and myocardial oxygen consumption. The effects of these drugs on cardiac workload also make them very effective in the treatment of angina. The calcium-channel blockers available in immediate release and sustained release forms that are used in treating hypertension include amlodipine (Norvasc), felodipine (Plendil), isradipine (generic), and nicardipine (Cardene). Other calcium-channel blockers are safe and effective for treating hypertension only if they are given as sustained release or extended release preparations. These include diltiazem (Cardizem CD), nifedipine (Procardia XL), nisoldipine (Sular), and verapamil (Calan SR). Clevidipine (Cleviprex) is only available in IV form for short-term management of hypertension when an oral calcium-channel blocker cannot be used.
Calcium-channel blockers inhibit the movement of calcium ions across the membranes of myocardial and arterial muscle cells, altering the action potential and blocking muscle cell contraction. This effect depresses myocardial contractility, slows cardiac impulse formation in the conductive tissues, and relaxes and dilates arteries, causing a fall in BP and a decrease in venous return.
Calcium-channel blockers are given orally and are generally well absorbed, metabolized in the liver, and excreted in the urine. These drugs cross the placenta and enter breast milk (see Contraindications and Cautions). Nicardipine and clevidipine are available in IV form for short-term use when oral administration is not feasible.
These drugs are contraindicated in the presence of allergy to any of these drugs to prevent hypersensitivity reactions; with heart block or sick sinus syndrome, which could be exacerbated by the conduction-slowing effects of these drugs; and with renal or hepatic dysfunction, which could alter the metabolism and excretion of these drugs. Although there are no well-defined studies about effects during pregnancy, fetal toxicity has been reported in animal studies; therefore, these drugs should not be used during pregnancy unless the benefit to the mother clearly outweighs any potential risk to the fetus because of the potential for adverse effects on the fetus or neonate. Because of the potential for serious adverse effects on the baby, another method of feeding the infant should be used if these drugs are required during lactation.
1. Your patient is prescribed a calcium channel blocker. As the nurse you know that these medication works to block calcium channels in what areas of the body? Select all that apply:
A. Vagal nerve cells
B. Vascular smooth muscle
C. Cardiac nodal tissue
D. Peripheral nervous cells
E. Cardiac myocytes
答案Answers 1. B, C, and E. Rationale: Calcium channel blockers work to block the L-type calcium channels in the vascular smooth muscle, cardiac myocytes, and cardiac nodal tissue. When the calcium channels of these areas are blocked they will decrease contraction of these cells, which will provide vasodilation, decrease in heart rate, and decrease in strength of heart contractions. Remember there are different types of calcium channel blockers, and some are more selective to the vascular smooth muscle, while some are more selective to the myocardium.
当前位置：
