DIltiazem

DIltiazem
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  • Why is Diltiazem prescribed & what does it do?
  • The physician has prescribed a Calcium Channel Blocker, Diltiazem to treat your atrial fibrillation, which will also help with your high blood pressure and will help to relieve your chest pain.
  • I feel like my heart is racing and I have an elephant sitting on my chest.
  • 147 BP: 165/90 98% 
  • Thanks doc.
  • Diltiazem works to decrease the force and rate of your heart's contraction and the rate electrical impulses are transmitted through your heart.  
  • What are possible adverse effects of Diltiazem & what should we monitor for?
  • So we will carefully monitor the patient's heart rhythm & rate, BP, & cardiac function during the procedure. Sedation also increases the risk of hypotension when taking Diltiazem.
  • This patient is taking Diltiazem, what do we need to monitor during the EPS?
  • DIltiazem can cause widened QRS and prolonged QT interval, bradycardia, hypotension, & heart failure due to suppression of cardiac function.
  • 95 BP: 130/75 99% 
  • What does the patient need to know before going home on Diltiazem?
  • Drinking grapefruit juice can lead to toxicity (decreased HR & BP) & should be avoided while taking Diltiazem.
  • Do you have any other questions for me?
  • While taking Diltiazem at home, you will need to monitor & keep a log of your BP at home, watch for swelling in legs, change positions slowly & notify yourdoctor if you experience chest pain, swelling,or if your HR is <50 bmp or systolic BP is <90 mmHg
  • Can I still drink my grapefruit juice with breakfast?
  • I will make sure to talk to my doctor before taking any of the medications that may interact with Diltiazem.
  • 76 BP: 120/70 98% 
  • I will make sure not to prepare grapefruit juice for him & help him take his BP at home.
  • Diltiazem is used to treat angina pectoris (coronary vasodilation),hypertension (systemic vasodilation) & cardiac dysrythmias such as atrial fibrillation (decreased ventricular rate), atrial flutter, & SVT. It works by blocking calcium channels in the peripheral arteries & the heart muscle and AV & SA nodes causing arterial vasodilation & decreased force of contraction, decreased heart rate, and slows the rate of conduction through the AV node.
  • I have also scheduled an electrophysiology study so we can identify the cause of your afib, locate accessory pathways, and make sure this medicine is effective.
  • Potential complications include orthostatic hypotension, widened QRS complex and prolonged QT interval, peripheral edema, constipation, badycardia, heart failure due to suppression of cardiac function, acute toxicity, & Stevens-Johnson Syndrome. 
  • Diltiazem increases digoxin levels, causes bradycardia, AV block, or heart failure when taken with beta-blockers, & may cause bradycardia & decreased cardiac output when given with amiodarone. Taking azole antifungals, clarithromycin, erythromycin, or HIV drugs may increase Diltiazem levels & effect. Taking Diltiazem with statins increases risk of statin toxicity & can cause toxicity when taken with cyclosporines. Consult your provider before taking any of these medications. 
  • Not right now, but I have the number to call if I do at home.
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