- Body system
- Cardiovascular
- Name stem
- -dipine (dihydropyridines)
- Drug cards
- 2 in this guide
Drugs in this class
Other examples: Nifedipine, Nicardipine, Felodipine, Verapamil, Clevidipine.
How calcium channel blockers work
Block calcium entry into vascular smooth muscle and, for verapamil and diltiazem, into heart muscle and the conduction system.
Uses
- Hypertension
- Angina, including vasospastic angina
- Rate control in atrial fibrillation (diltiazem, verapamil)
- Raynaud phenomenon (nifedipine)
Adverse effects
- Peripheral edema
- Headache and flushing
- Hypotension and dizziness
- Bradycardia and constipation (verapamil, diltiazem)
- Gingival hyperplasia
Nursing considerations
- Check blood pressure and heart rate before each dose.
- Avoid verapamil and diltiazem in heart failure with reduced ejection fraction and use caution with beta blockers.
- Do not crush extended-release forms. Immediate-release nifedipine is avoided for hypertension (sudden drops in blood pressure).
Patient teaching
- Grapefruit juice raises the levels of several drugs in this class.
- Report ankle swelling, dizziness or a slow pulse.
- Rise slowly.
Calcium channel blockers NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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A patient on amlodipine has bilateral ankle swelling with clear lungs and stable weight. What is the most likely cause?
Show answer
Answer A: An expected effect of vasodilation Peripheral edema is a common effect of dihydropyridine calcium channel blockers and comes from arteriolar dilation, not fluid overload.
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Before giving IV diltiazem for atrial fibrillation, which assessment matters most?
Show answer
Answer C: Heart rate and blood pressure Diltiazem slows AV conduction and lowers blood pressure; bradycardia and hypotension are the main risks.
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Which drink should the nurse tell a patient to ask about before using while taking a calcium channel blocker?
Show answer
Answer B: Grapefruit juice Grapefruit inhibits CYP3A4 and can raise levels of several calcium channel blockers.
Frequently asked questions
What are calcium channel blockers?
Calcium channel blockers relax blood vessels. Dihydropyridines (the -dipine drugs) mainly lower blood pressure; verapamil and diltiazem also slow the heart rate.
How do calcium channel blockers work?
Block calcium entry into vascular smooth muscle and, for verapamil and diltiazem, into heart muscle and the conduction system.
What are examples of calcium channel blockers?
Amlodipine, Diltiazem, Nifedipine, Nicardipine, Felodipine, Verapamil and Clevidipine.
What are the nursing considerations for calcium channel blockers?
Check blood pressure and heart rate before each dose. Avoid verapamil and diltiazem in heart failure with reduced ejection fraction and use caution with beta blockers.