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Verapamil is a class-IV antiarrhythmic and more effective than digoxin in controlling ventricular rate. [19] Verapamil is not listed as a first line antihypertensive agent by the guidelines provided by JAMA in JNC-8. [20] However, it may be used to treat hypertension if patient has co-morbid atrial fibrillation or other types of arrhythmia. [17 ...
Skeletal formula of verapamil. Phenylalkylamine calcium channel blockers are relatively selective for myocardium, reduce myocardial oxygen demand and reverse coronary vasospasm, and are often used to treat angina.
Medications to treat the toxic effects include: intravenous fluids, calcium gluconate, glucagon, high dose insulin, vasopressors and lipid emulsion. [1] [2] Extracorporeal membrane oxygenation may also be an option. [1] More than ten thousand cases of calcium channel blocker toxicity were reported in the United States in 2010. [2]
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Cardiovascular agents generally have narrow therapeutic indices, implying that small differences in dose or blood concentration may give rise to adverse drug reactions. [45] Serious acute toxicity may result from accidental, intentional or iatrogenic overdose. [46] Therefore, patients need to be aware of any unusual and serious side effects.
Amlodipine, sold under the brand name Norvasc among others, is a calcium channel blocker medication used to treat high blood pressure, coronary artery disease (CAD) [10] and variant angina (also called Prinzmetal angina or coronary artery vasospasm, among other names). [11]
C max is the maximum (or peak) serum concentration that a drug achieves in a specified compartment or test area of the body after the drug has been administered and before the administration of a second dose. [1] It is a standard measurement in pharmacokinetics.
TI = TD50 / ED50, where TD50 is the dose at which toxicity presents in 50% of the population, and ED50 is the dose needed to produce 50% of maximal response. [35] From the equation, a high TI indicates that the drug needs a high dose to induce toxicity in 50% of the population or a low dose to achieve the minimum effective dose, and vice versa.