Quick Recall
Patient N is a 57 yo man with a history of atrial fibrillation and is diagnosed with classic angina. Which of the following would be contraindicated in this patient?
- A. diltiazem
- B. nifedipine
- C. metoprolol
- D. warfarin
The correct answer is "B. Nifedipine". Nifedipine is a "dihydropyridine" type L-type calcium channel blocker. These drugs are vascular-selective, and will produce a fall in mean arterial blood pressure. This effect will reduce the AVN ERP by baroreceptor reflex. This is not an effect you want to produce in a patient with both AFib & angina of effort, because it will increase ventricular rate - and increase the likelihood of both an anginal attack, or a myocardial infarction.
A-Diltiazem is used to treat high blood pressure and to control angina (chest pain). Diltiazem is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart.
C
D
C
A
A (calcium-channel blocker)
Metoprolol
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