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Z- Calcium Channel Blockers in management of HTN.pptx

Calicium channel blockers in HTN

Health & Medicine◦
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Calcium channel blockers Presented by : KAWALAY STEVEN
 INTRODUCTION  CLASSIFICATION  MECHANISM OF ACTION  PHARMACOLOGICAL ACTIONS  PHARMACOKINETICS  USES  ADVERSE EFECTS  CONTRAINDICATIONS  SUMMARY Layout of the presentation :
INTRODUCTION.. also known as calcium antagonists.  prevent calcium from infiltrating the cells of the heart and blood vessel walls. relaxes and widens blood vessels of the heart within the arterial walls, promoting lowered blood pressure. may also slow the heart rate, relieve chest pressure and control an irregular heartbeat.
Indications of Calcium Channel Blockers  they are first line antihypertensive drugs.  the onset of antihypertensive action is quick.  monotherapy with CCBs is effective in about 50% of the hypertensives.  can also be used for treating angina.
Classification of CCBs  PHENYLAKYLAMINES • Verapamil Very  1,4-DIHYDROPYRIDINES • Nifedipine , Amlodipine etc… Nice  BENZOTHIAZEPINES • Diltiazem Drugs
 1,4 dihydopyrimidines are selective for the arteriolar beds.  The phenylalkylamines and benzothiazepines are selective for the atrioventricular node.
Short-acting • nifedipine, dilatiazem, verapamil Long-acting • amlodipine, felodipine, isradipine, nicardipine, nisoldipine,
Mechanism of action.. o Calcium channels are of 5 subtypes- L, N, T, P, and R. o L-type in cardiac and smooth muscle cells.
Moa : CCBs block voltage sensitive L- type Ca channels by binding to specific site on the α-1 subunit. Prevent entry of Ca into cell. No excitation-coupling reaction in heart and vascular smooth muscles.
 1,4 dihydopyrimidines are selective for the arteriolar beds.  Phenylalkylamines and  benzothiazepines are selective for the atrioventricular node.
 Increase the time that Ca2+ channels are closed.  Relaxation of the arterial smooth muscle.  Significant reduction in afterload.  Coronary vasodilatation. PHARMACOLOGICAL ACTIONS..
PHARMACOKINECTICS..  well absorbed through GIT.  first pass metabolism.  highly bound to plasma proteins.  metabolized in liver.  excreted through urine.
USES OF CCBs.. 1. angina pectoris - Due to decrease in myocardial oxygen consumption, and dilatation of coronary arteries. 2. supraventicular arrhythmias - because of its depressant action on S-A and A-V nodes. 3. hypertension - they control blood pressure by their vasodilatory effect. 4. Migraine 5. raynaud’s phenomenon - due to their vasodilatory property.
ADVERSE EFFECTS..  Postural hypotension  palpitation  reflex tachycardia  edema  dizziness  constipation  sedation  A-V block  headache  fatigue  lowered B.P.
CONTRAINDICATIONS o Heart failure o Bradycardia o Atrioventricular block. o Dihydropyridine calcium-channel blockers should not be used in people with uncontrolled heart failure.
SUMMARY..
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