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Diltiazem

Diltiazem

(Science: chemical) a benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic.

Pharmacological action: antihypertensive agents, calcium channel blockers, cardiovascular agents, teratogens, vasodilator agents. Direct, potent negative chronotrope with only mild negative inotropic effect; slows conduction in av node; coronary vasodilation with less systemic vasodilation than verpamil.

chemical name: 1,5-Benzothiazepin-4(5H)-one, 3-(acetyloxy)-5-(2-(dimethylamino)ethyl)-2,3-dihydro-2-(4-methoxyphenyl)-, (2S-cis)-

Uses: control ventricular response with atrial fibrillation

Dose: 0.25 mg/kg iv over 2 minutes May repeat at 0.35 mg/kg after 15 minutes. Maintenance infusion at 5 - 15 mg/hr.

potential complications: less hypotension than with verapamil since less vasodilation and myocardial depression; bradycardia; may exacerbate av block; synergistic interaction with beta blockers; relatively contraindicated with congestive heart failure.

Note: diltiazem can accelerate heart rate and decrease bloo 46f d pressure, especially in patients with Wolff-Parkinson-White or wide-complex tachycardia.


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