Indications: Treatment of essential hypertension in the extended release form. 适应症：延长释放型药物原发性高血压的治疗
Actions:Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells, depressing the impulse and leading to slowed conduction, decreased myocardial contractility, and dilation of arterioles, which lowers BP and decreases myocardial oxygen consumption. 作用：抑制钙离子运动通过心脏和动脉肌细胞膜，降低冲动引起传导减缓，减少心肌收缩，小动脉扩张，从而降低BP和减少心肌耗氧量。
Pharmacokinetics:药代动力学
Route Onset Peak Duration
Oral, extended release 30-60 min 6-11 h 12 h
途径 起效 达峰 持续时间
口服 延长释放型 30-60 min 6-11 h，12 h
T1/2: 5 to 7 hours; metabolized in the liver and excreted in the urine. 半衰期：5-7小时；代谢于肝，随尿排出
Indications:Severe hypertension, maintenance of controlled hypotension during anesthesia, acute heart failure. 适应症：严重高血压，麻醉期间低血压的维持，急性心衰
Actions:Acts directly on vascular smooth muscle to cause vasodilation and drop of BP; does not inhibit CV reflexes and tachycardia; renin release will occur. 作用：直接作用于血管平滑肌，引起血管扩张和血压下降；不抑制CV反射和心动过速；可出现肾素释放。
Pharmacokinetics:药代动力学
Route Onset Peak Duration
IV 1-2 min Rapid 1-10 min
途径 起效 达峰 持续时间
IV 1-2 min 迅速 1-10 min
T1/2: 2 minutes; metabolized in the liver and excreted in the urine. 半衰期：2分钟；代谢于肝，随尿排出
Adverse Effects: Apprehension, headache, retrosternal pressure, palpitations, cyanide toxicity, diaphoresis, nausea, vomiting, abdominal pain, irritation at the injection site. 不良效应：恐惧、头痛、胸骨后压迫感、心悸、氰化物中毒、出汗、恶心、呕吐、腹痛、注射部位炎症
—————Video—————
Calcium-Channel Blockers – Mechanisms of Action
—————Vocabulary—————
1. A patient is prescribed Verapamil for treatment of a supraventricular arrhythmia. As the nurse you know that this calcium channel blocker will help control the heart rate and rhythm by causing which of the following changes in the heart? Select all that apply.
A. Negative inotropic effect
B. Positive inotropic effect
C. Negative chronotropic effect
D. Positive chronotropic effect
E. Negative dromotropic effect
F. Positive dromotropic effect 2. Which type of calcium channel blockers below are considered non-dihydropyridines and can provide anti-arrhythmic effects? Select all that apply.
A. Nifedipine
B. Diltiazem
C. Amlodipine
D. Verapamil
奥医教育“在线自测”题库
ISPN/RN复习练习、效果检验一站完成。
答案Answers 1. A, C, and E. Rationale: Verapamil is a calcium channel blocker that is a non-dihydropyridine (phenylalkylamine). It decreases the contractility of the heart muscle cells, which decreases the strength of heart contractions, and this causes a NEGATIVE inotropic effect. In addition, Verapamil decreases the contraction of nodal tissue cells, specifically the SA and AV nodal tissue. Therefore, by decreasing the SA node (pacemaker of the heart), the heart rate will decrease, and this causes a NEGATIVE chronotropic effect. And by decreasing the AV node (gatekeeper), the speed of conduction will decrease, which will cause a NEGATIVE dromotropic effect. 2. B and D. Rationale: Verapamil and Diltiazem are calcium channel blockers that are non-dihydropyridine. They are more selective to the myocardium when compared to dihydropyridine (Nifedipine and Amlodipine), which are more selective to the vascular system. Therefore, non-dihydropyridines can provide anti-arrhythmic effects.
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