In this video, Dr. Krishan Kataria provides in-depth summary of clinical pharmacology of amlodipine or norvasc. You will learn about mechanism of action, indications, side-effects, and much more about amlodipine. A must watch for medical students, interns, residents, doctors, nurses, nursing students, physician assistants and nurse practitioners.
Hello friends welcome to i’m exploration in this video you will learn about amlodipine which is also known by the trade name of norwask you will learn about the mechanism of action indications clinical trials data and much more about american and that’s me my name is kk i’m a board-certified internal medicine physician starting with the mechanism of action the
Contractile process of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into the cells through specific ion channels amorodipine is a dihydropyridine calcium channel blocker that inhibits calcium iron influx across cell membranes selectively with a greater effect on vascular smooth muscle than on cardiac muscle
Cells amodpin is a peripheral arterial vasodilator that acts directly on vascular smooth muscles to cause a reduction in peripheral vascular resistance thereby reducing blood pressure moving on to the indications amlodipine is indicated for the treatment of hypertension it can be used alone or in combination with other antihypertensives amlodipine is also indicated
For symptomatic treatment of chronic stable angina either alone or in combination with other anti-anginal agents another important indication of amlodipine is for the treatment of confirmed or suspected vasospastic angina although off-label it is also used for reynolds disease how does amlodipine work in vasospastic angina amlodipine causes relaxation of coronary
Vascular smooth muscles and coronary vasodilation it increases myocardial oxygen delivery to help patients with vasospastic angina let’s discuss some clinical trials data once daily dose of amlodipine produced statistically significant placebo-corrected reductions in supine and standing blood pressure at 24 hour post dose the average blood pressure reduction was
12 over 6 millimeter mercury in the standing position and 13 over 7 millimeter mercury in the supine position in patients with mild or moderate hypertension maintenance of blood pressure effect over the 24-hour dosing interval was observed the effect on systolic blood pressure was greater in older population perhaps because of greater baseline systolic pressure
Amlodipine may also be used in patients with angiographically documented coronary artery disease without heart failure or without ejection fraction of less than 40 percent clinical studies have shown reduced hospitalization for angina and prevention of free vascularization procedures in patients taking american it should be noted that android pin is not the first line
In this indication beta blockers are preferred let’s test your knowledge do you know what is the difference between dihydropyridine and non-dihydropyridine calcium channel blockers we will discuss the answer at the end of the presentation moving on to the doses american is available as a tablet the dose can range from 2.5 to 10 milligram once daily the recommended
Dose for chronic stable or vasospastic angina is 5 to 10 milligram daily the bioavailability of amlodipine is not altered by the presence of food for geriatric patients lower initial dose should be used and blood pressure should be monitored more closely let’s talk about dosing of amlodipine in hepatic and renal dysfunction the pharmacokinetics of amlodipine are
Not significantly influenced by renal impairment therefore patients with renal failure may continue to receive the usual initial dose in patients with severe hepatic impairment titrate the dose of americans slowly monitor patients blood pressure and heart rate periodically what are some of the warnings and precautions to remember american may lead to symptomatic
Hypotension especially in patients with severe aortic stenosis amnodipine has a gradual onset of action therefore acute hypotension is less likely patients may experience worsening angina and acute mi after starting or increasing the dose of amlodipine especially in patients with severe obstructive coronary artery disease moving on to the contraindications it is
Contraindicated in patients with known sensitivity to amyloid pain let’s go over some more side effects in clinical trials discontinuation of amrodipine because of adverse reactions was seen in only about 1.5 percent of patients and it was not significantly different from discontinuation rate in the placebo group common side effects include leg and ankle edema
Dizziness flushing and palpitations the risk increases with higher doses other side effects include fatigue nausea abdominal pain and somnolence amlodipine may also lead to bradycardia constipation and muscle cramps amlodipine has not been associated with clinically significant changes in routine laboratory studies let’s discuss some important drug drug interactions
When used with sildenafil monitor for hypotension limit the dose of simvastatin in patients on amdi pain to 20 milligram daily amlodipine may increase the exposure of symbiostatin when used together amlodipine may increase the systemic exposure of cyclosporine or technolomas therefore frequent monitoring of trough levels of cyclosporine and technolomas is recommended
The dose should be adjusted appropriately calcium channel blockers may be used to treat hypertension in pregnant women but please note knife fedepine is the preferred agent amlodipine is present in breast milk consider risk versus benefits in patients who are breastfeeding moving on to some pharmacokinetic and pharmacodynamic properties of amlodipine with chronic
Once daily oral administration blood pressure lowering effect is maintained for at least 12 hours peak concentration is achieved between 6 to 12 hours american is extensively metabolized by hepatic metabolism iteraconazole and clarithromycin may increase the plasma concentration of amlodipine this wraps up our discussion on amlodipine you can download this
Presentation by following the link in the description below if you found this information useful please like this video we are building something worthwhile at im exploration for more educational videos make sure you subscribe to our channel coming back to the answer to our earlier question what is the difference between dihydropyridine and non-dihydropyridine
Calcium channel blockers dihydropyridine calcium channel blockers are potent vasodilators with little or no negative effect on cardiac contractility or conduction on the other hand non-dihydropyridine calcium channel blockers are less potent vasodilators they have a greater depressive effect on cardiac contraction and contractility examples of non-dihydropyridine
Calcium channel blockers are verapamil and diltiazem that’s it for this video we wish you all the happiness and success until next time keep learning and keep growing
Transcribed from video
Amlodipine or Norvasc: What you MUST know? By IMExploration
