Calcium Channel Blockers Overview
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Questions and Answers

What is a critical nursing intervention when administering calcium channel blockers to patients?

Patients should be instructed to report dizziness and symptoms of an irregular heart rate.

Why should patients avoid grapefruit juice while taking calcium channel blockers?

Grapefruit juice inhibits the hepatic metabolism of calcium channel blockers, potentially leading to increased drug levels.

How do azole antifungals and certain antibiotics affect the metabolism of cardiovascular agents?

They can inhibit drug metabolism, leading to elevated levels and potentially increased effects or toxicity.

What precautions should be taken for patients with heart failure when prescribing calcium channel blockers?

<p>All calcium channel blockers should be used cautiously in patients with heart failure.</p> Signup and view all the answers

What are common adverse effects of beta blockers that a nurse should monitor?

<p>Common adverse effects include dizziness, slowing of the pulse, fatigue, and hypotension.</p> Signup and view all the answers

What is the impact of combining statins with calcium channel blockers?

<p>Statins may have an increased risk of toxicity when their metabolism is inhibited by calcium channel blockers.</p> Signup and view all the answers

List one class of medications that should be monitored for interaction due to their effect on cytochrome P450 isoenzymes.

<p>Drugs such as azole antifungals and certain antibiotics should be monitored.</p> Signup and view all the answers

In managing patients with Prinzmetal angina, how do calcium channel blockers provide therapeutic benefits?

<p>They cause vascular relaxation by decreasing calcium influx, which can prevent or reverse coronary spasms.</p> Signup and view all the answers

What physical assessments should a nurse perform to evaluate perfusion when administering phosphodiesterase inhibitors?

<p>The nurse should inspect skin and mucous membranes for color, and check nail beds and capillary refill.</p> Signup and view all the answers

Why are phosphodiesterase inhibitors contraindicated in patients with severe aortic or pulmonic valvular disease?

<p>These conditions could be exacerbated by the increased contractions induced by the medications.</p> Signup and view all the answers

What laboratory tests should be monitored during the administration of drugs like inamrinone and milrinone?

<p>Laboratory tests should include serum electrolyte levels, complete blood count, and renal and hepatic function tests.</p> Signup and view all the answers

What is the onset and peak time of intravenous inamrinone and milrinone administration?

<p>The onset is immediate, and the peak effect occurs within 10 minutes.</p> Signup and view all the answers

Describe the significance of obtaining a baseline ECG before administering phosphodiesterase inhibitors.

<p>A baseline ECG helps identify the patient's heart rate and rhythm, establishing a reference for any changes that may occur.</p> Signup and view all the answers

What is the primary route of administration for inamrinone and milrinone, and why is it used?

<p>The primary route is intravenous (IV) due to their immediate effects and wide distribution after injection.</p> Signup and view all the answers

What can a nurse assess in a patient’s abdomen to gauge gastrointestinal motility when administering these medications?

<p>The nurse should examine the abdomen for distention and auscultate bowel sounds.</p> Signup and view all the answers

What are the primary metabolites of inamrinone and milrinone, and how are they excreted?

<p>These drugs are metabolized in the liver and primarily excreted in the urine.</p> Signup and view all the answers

What nursing considerations should be taken when administering calcium channel blockers (CCBs) to patients with coronary artery disease (CAD)?

<p>Monitor the patient's heart rate and blood pressure regularly, as CCBs can cause hypotension and bradycardia.</p> Signup and view all the answers

How does the metabolism of amlodipine get affected by certain drug interactions?

<p>Erythromycin and similar antibiotics can inhibit amlodipine's metabolism, potentially enhancing its antihypertensive effects.</p> Signup and view all the answers

What are the key patient responses to monitor after administering nitrates for angina pectoris?

<p>Monitor for relief of chest pain, blood pressure changes, and signs of side effects like headache or dizziness.</p> Signup and view all the answers

What contraindications exist for the use of bile acid sequestrants?

<p>Bile acid sequestrants are contraindicated in patients with an allergy to these agents or complete biliary obstruction.</p> Signup and view all the answers

How can the combination of calcium channel blockers and beta-blockers affect a patient's heart rate and blood pressure?

<p>These combinations can exacerbate bradycardia and hypotension, necessitating close monitoring of the patient's vital signs.</p> Signup and view all the answers

What should nurses monitor for in patients taking cholestyramine to manage cholesterol levels?

<p>Monitor for gastrointestinal side effects and ensure the patient is adhering to the recommended administration schedule.</p> Signup and view all the answers

What is the significance of recognizing symptoms of ischemic heart disease in patients treated with cardiovascular agents?

<p>Recognizing ischemic symptoms allows for timely intervention and adjustment of treatment to prevent further myocardial damage.</p> Signup and view all the answers

Why is it essential to assess the patient's response to treatment when using CCBs for atrial fibrillation?

<p>Assessing patient response helps evaluate the effectiveness of CCBs in controlling heart rhythm and managing symptoms.</p> Signup and view all the answers

Study Notes

Calcium Channel Blockers

  • Decrease calcium influx into smooth muscle
  • Cause vascular relaxation
  • Reverse or prevent coronary vessel spasms
  • Used for conditions such as angina, hypertension, supraventricular tachycardia
  • Effective for coronary artery spasms
  • Three classes: phenylalkylamines, benzothiazepines, and dihydropyridines
  • Common examples: verapamil, diltiazem, and amlodipine

Interactions

  • Azole antifungals, clarithromycin, erythromycin, and HIV drugs can increase levels and effects of calcium channel blockers
  • Statins can increase statin toxicity
  • Cyclosporine can cause possible toxicity of either drug
  • Grapefruit juice inhibits metabolism, leading to higher blood levels and stronger effects

Nursing Considerations

  • Tell patients to report dizziness and symptoms of an irregular heart rate
  • Warn patients to avoid grapefruit juice
  • Use cautiously in patients with heart failure
  • Monitor skin and mucous membranes, nail beds, and capillary refill
  • Examine abdomen for distention and auscultate bowel sounds
  • Assess voiding patterns and urinary output
  • Obtain baseline ECG to evaluate rate and rhythm
  • Monitor laboratory tests, including serum electrolytes, complete blood count, and renal and hepatic function tests

Phosphodiesterase Inhibitors

  • Contraindicated in allergies to the drugs or bisulfites
  • Contraindicated in severe aortic or pulmonic valvular disease
  • Distributed after injection or rapid GI absorption
  • Excreted in urine

Bile Acid Sequestrants

  • Act while in the intestine
  • Excreted directly in feces
  • Cholestyramine must be mixed with liquids
  • Colestipol is available in powder and tablet form
  • Colesevelam is available in tablet form
  • Contraindicated in allergies to bile acid sequestrants
  • Contraindicated in complete biliary obstruction

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Description

This quiz covers the fundamentals of calcium channel blockers, including their mechanisms, interactions, and nursing considerations. Test your knowledge on the different classes of these medications and their uses in treating conditions like angina and hypertension.

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