Diltiazem


Diltiazem hydrochloride/Cardizem, Dilzem, Vasocardol        Preg risk C

Classifications: calcium channel blocker (antianginal agent)(antiarrhythmic)

Indication: Vasospastic angina(Prinzmetal's variant angina), classic chronic angina pectoris, atrial fibrillation,atrial flutter, tachycardia

Action: V BP, cardiac workload, and O2 consumption. 

Relaxes muscle contraction or other autonomic blockers

Adverse:

  CNS: headache, dizziness, asthenia, somnolence

    CV: oedema, arrhythmias, flushing, bradycardia, hypotension, conduction abnormalities, heart failure, AV block, abnormal ECG

     GI: nausea, constipation, abdo discomfort

    Hepatic: acute hepatic injury

     Skin: rash

Contraindications: hypersensitivity, sick sinus syndrome, second or third-degree AV block, bp below 90 mm Hg, acute MI or pulmonary congestion, renal or hepatic dysfunction.

Care considerations: use cautiously in elderly adults or those with HF, impaired hepatic or renal function. Monitor BP, if bp below 90, notify subscriber.

Dose: 30 mg PO tid, or qid

Drug- Drug: anaesthetics- use cautiously, cimetidine(may inhibit metabolism of diltiazem), cyclosporin(increased levels lead to toxicity), digoxin(monitor for toxicity), propanol and other beta blocker(precipitate HF)

Teaching: advise to avoid driving,; may be prescribed with SL glyceryl trinatrate for angina-urge compliance;swallow SR capsules- no crush, cut or chew.

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