NCLEX Review: Verapamil (Verelan) – Mechanism of Action, Uses, Side effects, Contraindications, and Nursing considerations
Hi everyone this is nurse ryan and today we’re going to be talking about the drug varapamil also known by the brand names veralin and others you can use the timestamps in the video description to jump ahead verapamil belongs to the calcium channel blocker drug classification or ccbs for short first let’s quickly go over some of the effects of calcium in our muscles
Without getting into too much detail calcium is required during contraction of smooth and cardiac muscle in simple terms contraction of vascular smooth muscle which is the muscle that makes up the blood vessels results in vasoconstriction which increases blood pressure this is because a constricted or narrow blood vessel results in a higher blood pressure secondly
Again in simplified terms contraction of cardiac muscle increases the workload of the heart essentially this increases how hard the heart is pumping which as a result requires more energy and oxygen so again two things that we need to know about calcium in our muscles first it increases blood pressure and second it increases the workload of our heart which makes it
Require more energy and oxygen now varapamil works by blocking calcium channels in these smooth and cardiac muscles preventing calcium from entering the cells and without as much calcium in our vascular smooth muscle we now get less vascular contraction this means that the blood vessels relax or open up also called vasodilation which helps to lower blood pressure
With less contraction of cardiac muscle cells we get a decrease in the workload of the heart making it easier for the heart to pump so why would we want to reduce blood pressure or reduce the workload of the heart well varapamil can be taken orally for the treatment of hypertension which is elevated blood pressure and for angina which benefits from a reduced
Workload of the heart it can also be taken intravenously for atrial fibrillation and atrial flutter calcium channel blockers have many side effects so we’ll just go over some of the important ones many of the side effects of calcium channel blockers stem from their effect of vasodilation vasodilation can cause hypotension which may manifest as dizziness weakness
Headaches syncope which is a loss of consciousness due to low bp orthostatic hypotension and more calcium channel blockers may also cause dysrhythmias and heart palpitations due to their effect on cardiac muscle just some of the other side effects include bradycardia or low heart rate weight gain and edema sleep disturbances and more calcium channel blockers
Are contraindicated in clients with cardiogenic shock which is associated with low blood pressure avoid drinking grapefruit juice with calcium channel blockers as they can increase the drug absorption resulting in hypotension and changes in heart rate use calcium channel blockers cautiously in clients with low blood pressure or low heart rate acute myocardial
Infarction and clients taking digoxin or other anti-hypertensive medications always remember to assess and monitor for side effects of calcium channel blockers monitor blood pressure and heart rate before administration typically if systolic blood pressure is less than 90 or if apical heart rate is less than 60 beats per minute hold the medication and notify the
Provider especially for elderly clients instruct clients to avoid rapid changes in positions such as changing from sitting to standing to reduce the risk of orthostatic hypotension and falls if sublingual nitroglycerin is ordered and available it is the preferred treatment option for acute angina chest pain as with most all anti-hypertensive medications it is
Important not to discontinue calcium channel blockers abruptly and to instead gradually taper the dose according to the provider’s instructions to reduce the risk of a hypertensive crisis and lastly do not crush extended release tablets and that’s about it for the basics of varapamil if this video has helped you out please consider leaving a like and subscribe
I would really appreciate it if you have any questions or would like me to review a specific drug or topic please let me know in the comments and thanks for watching
Transcribed from video
Verapamil (Verelan) Nursing Drug Card (Simplified) – Pharmacology By Nurse Ryan
