Dihydropyridine Calcium Channel Blockers

Dihydropyridine calcium channel blockers are used in the treatment of hypertension and for treatment of effort induced angina and vasospastic angina.  Drugs in this class decrease inward movement of calcium in heart and smooth muscle cells of coronary and peripheral arterioles, which results in vasodilation and decreased contractility of muscle cells.  Calcium channel blockers reduce oxygen demand, which is the reason these medications are used to treat effort induced angina. Coronary arteriole relaxation properties give rise to the indication for vasospastic angina.  Peripheral edema is very common. In addition, patients can develop heart blocks and dizziness especially in combination with other drugs that slow the AV node.

Class Drugs

• Amlodipine

• Felodipine

• Isradipine

• Nicardipine

• Nifedipine

• Nisoldipine

Class Mechanism of Action

Binds to and blocks L-type calcium channels

• Decreases inward movement of calcium in heart and smooth muscle cell of coronary and peripheral arterioles

• Results in relaxation of arteriolar smooth muscle cells

Class Applications

Hypertension

• Negative inotropy (decreased contractility of cardiac muscle)

• Arteriolar dilatation

Effort-Induced Angina

• Reduces myocardial oxygen consumption

Decreases contraction of cardiac muscle cells

• Decreases peripheral vascular resistance

Vasospastic Angina

• Decreases vasospasm, by relaxing arterioles

Class Adverse Effects

• AV Block

• Dizziness

• Flushing

• Headache

• Peripheral edema

Drug Table

Drug Name	Application	Comments	Image
Amlodipine			"Ammo" "Low" "Dipping"
Felodipine			"Feline" "Dipping"
Isradipine			"Israel" "Dipping"
Nicardipine			"Nicotine" "Dipping"
Nifedipine			"Knife" "Dipping"
Nisoldipine			"Nissan Old" "Dipping"