Verapamil (Isoptin, Verelan, Verelan PM, Calan, Bosoptin, Covera-HS)

Indications

  • Angina (see Coronary Artery Disease, [[Coronary Artery Disease]])
  • Cluster Headache Prophylaxis
  • Hypertension (see Hypertension, [[Hypertension]])
  • Migraine Prophylaxis (see Migraines, [[Migraines]])
  • Rate Control of AV Nodal-Mediated Arrhythmias
    • Atrial Fibrillation with Rapid Ventricular Response (see Atrial Fibrillation, [[Atrial Fibrillation]])
    • Supraventricular Tachycardia (SVT) with Rapid Ventricular Response (see Supraventricular Tachycardia, [[Supraventricular Tachycardia]])

Contraindications

Atrioventricular Heart Blocks

Hypotension (see xxxx, [[xxxx]])

  • Verapamil May Exacerbate Hypotension

Pharmacology

  • Non-Dihydropyridines (Phenylalkylamine) Calcium Channel Blocker (see Calcium Channel Blockers, [[Calcium Channel Blockers]])

Physiologic Effects

  • Atrioventricular Nodal Blockade: since calcium channels are especially concentrated in the sinoatrial and atrioventricular nodes within the heart
  • Class IV Anti-Arrhythmic
  • Coronary Vasodilation: via calcium channels located within vascular smooth muscle
  • Decreased Myocardial Oxygen Consumption
  • Minimal Systemic Vasodilation: via calcium channels located within vascular smooth muscle
    • Verapamil is relatively selective for the myocardium (compared to the dihydropyridine calcium channel blockers) and it therefore, causes less reflex tachycardia than the dihydropyridine calcium channel blockers
  • Negative Inotropy

Administration

  • PO:
  • IV:

Adverse Effects

Cardiovascular Adverse Effects

Atrioventricular Heart Blocks

Bradycardia (see Bradycardia, [[Bradycardia]])

  • May Occur

Hypotension (see Hypotension, [[Hypotension]])

  • Physiology: class effect (common to all calcium channel blockers)

Dermatologic Adverse Effects

  • Facial Flushing (see Flushing, [[Flushing]])

Endocrinologic Adverse Effects

Gastrointestinal Adverse Effects

Hematologic Adverse Effects

  • Ecchymosis

Neurologic Adverse Effects

Otolaryngologic Adverse Effects

Gingival Hypertrophy (see Gingival Hypertrophy, [[Gingival Hypertrophy]])

  • Physiology: class effect (observed with other calcium channel blockers, as well)

Renal Adverse Effects

  • Increased Urination

Rheumatologic Adverse Effects

Other Adverse Effects

  • xxx
  • xxx
  • xxx
  • xxx

Calcium Channel Blocker Intoxication


References

  • xxx