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Amlodipine, Felodipine
[
am loe' di peen][fe lo' di peen]
  • Calcium channel blockers are effective in treating hypertension because they reduce peripheral resistance.

  • Amlodipine and felodipine have relatively little effects on reducing myocardial contractility compared to verapamil or diltiazem.

  • Arteriolar vascular tone depends on free intracellular Ca2+ concentration:

    • Calcium channel blockers reduce transmembrane movement of Ca2+

    • reduce the amount reaching intracellular sites and therefore

    • reduce vascular smooth muscle tone.

  • All calcium channel blocks appear similarly effective for management of mild to moderate hypertension.

  • For low-renin hypertensive patients (elderly and African-American groups), Ca2+ channel blockers appear good choices for monotherapy (single drug) control.

  •  Adverse Effects

    • SA nodal inhibition may lead to bradycardia or SA nodal arrest. This effect is more prominent if beta adrenergic antagonists are concurrently administered.

    • GI reflux.

    • Negative inotropic effects are augmented if beta-adrenergic receptor antagonists are concurrently administered.

    • Calcium channel blockers should not be administered if the patient has SA or AV nodal abnormalities or in patients with significant congestive heart failure.