Calcium Channel Blockers

Calcium Channel Blockers

I Types
A. verapamil (calan)
B. diltiazem (Cardizem)
C. nifedipine (Procardia)
II Mechanism of Action
A. Cause peripheral arterial vasodilation
B. reduce myocardial contractility (negative inotropic action)
C. result: decreased myocardial O2 demand
III Indications
A. First line agents for tx of angina, HPN and supraventricular tachy arryth
B. short term mgmt of atrial fibrillation and flutter
IV Side effects
A. very acceptable side effects and safety profile
B. may cause:
1. hypotension
2. palpitations
3. tachycardia or bradycardia
4. constipation
5. nausea
6. dyspnea
V Nursing implications
A. blood levels should be monitored to ensure they are therapeutic
B. oral CCBs should be taken before meals and as ordered
C. pts should be encouraged to limit caffeine intake
D. before administering, perform a complete health history to determine presence of conditions that may be contraindications for use or call for cautious use
E. obtain baseline VS, including respiratory patterns and rate
F. access for drug interactions
G. Pts should not take any meds including OTC w/o checking w/dr
H. pts should report blurred vision, persistent headache, dry mouth, dizziness, edema, fainting, weight gain of over 2 lbs/day or 5lbs/week, pulse over 60 and dyspnea
I. fainitng from vasodilation and hypotension w/ alcohol consumption & hot baths
J. teach pts to change positions slowly
K. keep records of angina attacks incl: precipitating factors, number of pills taken, and therapeutic effects


For all: monitor for adverse reactions & therapeutic effects