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Non-Dihydropyridines (Cardio-selective) Main effect: Slows heart rate + decreases contractility Examples: Verapamil Diltiazem Primary use: Arrhythmias, angina, hypertension INDICATIONS Dihydropyridines: Hypertension (first-line) Chronic stable angina Raynauds phenomenon Hypertensive emergencies (IV nicardipine) Non-Dihydropyridines: Supraventricular tachycardia Atrial fibrillation rate control Angina Hypertension (not first-line alone) MECHANISM OF ACTION Inhibits calcium influx through L-type Ca channels Relaxes vascular smooth muscle Decreases myocardial oxygen demand Slows AV node conduction (non-dihydropyridines) SIDE EFFECTS Dihydropyridines: Peripheral edema Headache Flushing Reflex tachycardia Dizziness Non-Dihydropyridines: Bradycardia AV block Constipation (especially verapamil) Hypotension CONTRAINDICATIONS Severe hypotension Heart failure (reduced ejection fraction)** Sick sinus syndrome 2nd or 3rd degree AV block Concurrent beta-blocker use (for verapamil/diltiazem) (Dihydropyridines are safer in heart failure than non-dihydropyridines.) DRUG INTERACTIONS Beta-blockers bradycardia/heart block (avoid with verapamil & diltiazem) Grapefruit juice increases CCB levels Digoxin (verapamil increases levels) NURSING CONSIDERATIONS Monitor BP and HR before administration Educate patient about: Slow position changes (to prevent dizziness) Avoid grapefruit products Watch for edema, constipation, and bradycardia To view or add a comment, sign in : Severe hypercalcemia is more than just a lab abnormality it can be life-threatening

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