Isradipine

[iss-RAD-ih-peen] Pregnancy Category: C DynaCirc, DynaCirc CR [Rx] Classification: Calcium channel blocking agent

See also Calcium Channel Blocking Agents.

Action/Kinetics: Binds to calcium channels resulting in the inhibition of calcium influx into cardiac and smooth muscle and subsequent arteriolar vasodilation. Reduced systemic resistance leads to a decrease in BP with a small increase in resting HR. In clients with normal ventricular function, the drug reduces afterload leading to some increase in CO. Well absorbed from the GI tract, although it undergoes significant first-pass metabolism. Peak plasma levels: 1 ng/mL after 1.5 hr. Onset: 2—3 hr. Food increases the time to peak effect by about 1 hr, although the total bioavailability does not change. tV2 initial: 1.5—2 hr; terminal, 8 hr. Completely metabolized in the liver with 60%—65% excreted through the kidneys and 25%-30% through the feces. Maximum effect may not be observed for 2-4 wks.

Uses: Alone or with thiazide diuretics in the management of essential hyper-

ITRACONAZOLE

tension. Non-FDA Approved Uses: Chronic stable angina. Contraindications: Hypersensitivity, hypotension < 90 mm Hg, 2nd or 3rd degree heart block, sick sinus syndrome. Lactation. Special Concerns: Safety and effectiveness have not been determined in children. Use with caution in clients with CHF, especially those taking a beta-adrenergic blocking agent. Bio-availability increases in those over 65 years of age, in impaired hepatic function, and in mild renal impairment.

Side Effects: CV: Palpitations, edema, flushing, tachycardia, SOB, hypotension, transient ischemic attack, stroke, atrial fibrillation, ventricular fibrillation, MI, CHF, angina. CNS: Headache, dizziness, fatigue, drowsiness, insomnia, lethargy, nervousness, depression, syncope, amnesia, psychosis, hallucinations, weakness, jitteriness, paresthesia. Oral: Dry mouth, gingival hyperplasia. GI: Nausea, abdominal discomfort, diarrhea, constipation, dry mouth. Respiratory: Dyspnea, cough. Dermatologie: Pruritus, urticaria. Miscellaneous: Chest pain, rash, pollakiuria, cramps of the legs and feet, nocturia, polyuria, hyperhidrosis, visual disturbances, numbness, throat discomfort, leuko-penia, sexual difficulties. Drug Interactions Anesthetics / T Effect of isradipine Barbiturates / l Effect of isradipine Carbamazepine / T Effect of isradipine due to l breakdown by liver Fentanyl / Possible severe hypotension or T fluid volume Indomethaein / l Effect of isradi-pine

NSAIDs / l Possible effect of isradi-pine

Phenobarbital / l Effect of isradi-pine

Other drugs with hypotensive effects / T Effect of isradipine How Supplied: Capsule: 2.5 mg, 5 mg; Tablet, extended release: 5 mg, 10 mg

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