Verapamil
| Indications | angina, tachyarrhythmias |
|---|---|
| Mechanism of action | - non-dihydropyridine CCB - blocks L-type voltage gated Ca channels = prevents intracellular Ca influx - slows AV node conduction |
| Net effect | - negative inotropy - negative chronotropy - negative dromotropy (AV node blockade) - peripheral vasodilatation; vascular smooth muscle relaxation |
| Dose | |
| Pharmacokinetics | Absorption high 1st pass effect Distribution high plasma protein binding Metabolism: t½ 6-8h Elimination |
| Time course of action | |
| Adverse effects | heart failure, hypotension, bradycardia, heart block |
| Contraindications | beta blocker use!! WPW, accessory conducting pathways causing AF or flutter 2nd/3rd degree AV block, sick sinus, SAN block |