Calcium channel blockers

description, class of drug

Classes

dihydropyridines: nifedipine, amliodipine

non-dihydropyridines: verapamil, diltiazem

type here

good to combine with ACE/ARB

and beta blockers

stable angina
in ACS, generally only used acutely for ongoing ischemia when beta-blockers are contraindicated

blocks Ca²⁺ influx into VSMCs and cardiomyocytes, leading to vasodilation and decreased contractility
causes coronary/peripheral vasodilation, reducing contractility and MVO2

direct effect of reducing contractility may be counteracted by reduction in afterload and activation of

avoid short acting dihydropyridines, ie nifedipine, due to its drop in BP
non-dihydropyridines (verapamil and diltizaem) are negatively chronotropic and should generally be avoided in patients with poor LV function or HF

can cause headaches, flushing, dizziness

peripheral edema

constipation (verapamil)

bradycardia/heart block (verapamil, diltiaezm)

worsening heart failure