Calcium channel blockers on the NCLEX
CCBs: dihydropyridines vs non-dihydropyridines, when each is used, side effects, grapefruit juice interaction.
Two subgroups matter: dihydropyridines (-dipine, vascular-selective) and non-dihydropyridines (verapamil, diltiazem, cardiac-selective). The NCLEX tests when to use each.
Dihydropyridines (-dipine)
Amlodipine, nifedipine, felodipine. Vasodilation > cardiac effects. Used for HTN. Side effects: peripheral edema, flushing, reflex tachycardia.
Non-dihydropyridines
Verapamil, diltiazem. Cardiac > vascular. Used for HTN, SVT, AFib rate control. Side effects: bradycardia, constipation (verapamil), AV block.
Grapefruit juice
Inhibits metabolism → higher drug levels → more side effects. Counsel patients to avoid.
Don't combine non-DHP + beta-blocker
Both slow conduction. Risk of severe bradycardia and AV block.
Frequently asked
Which CCB for AFib rate control?
Diltiazem or verapamil (non-DHPs). Dihydropyridines don't slow the AV node.
Edema from amlodipine, what to do?
Common dose-related side effect. Switch to ARB or ACE; not relieved by diuretics.
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