Rapid Rx Quiz: Calcium-Channel Blockers
Calcium-channel blockers (CCBs) play a central role in the treatment of hypertension, angina, and certain cardiac arrhythmias and are among the most commonly prescribed drugs in the United States. Beyond their US Food and Drug Administration–approved uses, CCBs have found a place in treating several off-label conditions. With their widespread use, however, comes the responsibility of understanding their pharmacodynamics, drug-drug interactions, and potential toxicities.
How much do you know about CCBs? Test yourself with this short quiz.
Off-label uses for CCBs include Raynaud phenomenon, migraines, and subarachnoid hemorrhage. CCBs do not treat depression; in fact, their use has been associated with depression. Verapamil might reduce diastolic dysfunction, but this is not a mainstream use. The most common CCBs are relatively weight neutral.
Learn more about Raynaud phenomenon.
Including lightheadedness, specific adverse and serious adverse events from CCB use are bradycardia, constipation, headaches, flushing, worsening cardiac output, and peripheral edema, possibly from fluid redistributing from the intravascular space.
Learn more about dizziness and vertigo.
A recent study found that amlodipine was involved in the majority of overdose cases, accounting for 62% of all CCB overdoses. This far surpasses other agents such as lercanidipine (12%), diltiazem (11%), verapamil (10%), and felodipine (5%). The lower incidence of overdoses involving lercanidipine, diltiazem, verapamil, and felodipine corresponds with their declining presence in current hypertension treatment guidelines.
Although amlodipine is involved in more overdose cases overall, the study underscores that the severity of overdose varies significantly by CCB class. Nondihydropyridines, such as diltiazem and verapamil, were associated with markedly higher rates of life-threatening complications, including dysrhythmias (33-35% of cases) and intensive care unit (ICU) admissions (52% and 30%, respectively). In contrast, amlodipine showed much lower rates of dysrhythmias (1%) and ICU admissions (18%).
Learn more about CCB toxicity.
Many of the signs and symptoms of CCB toxicity are similar to normal CCB adverse events, making diagnosis challenging. A blood test can aid in diagnosis; abnormal findings that suggest CCB toxicity include acidosis, hyperglycemia, and hypokalemia. Neutrophilia has no established connection.
Learn more about CCB toxicity.
Combining diltiazem or verapamil with direct oral anticoagulants might increase risk for bleeding or clotting complications, though previous research has shown mixed results.
A recent study found no evidence of increased risk when direct oral anticoagulants were used alongside diltiazem or verapamil. However, patients who began direct oral anticoagulant therapy while already taking diltiazem had higher rates of overall mortality and cardiovascular-related death within 30 days, compared with those taking anticoagulants alone.
Learn more about diltiazem.
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Harvard Business Review
24 minutes ago
- Harvard Business Review
How to Phrase Your Questions When You Need Honest Answers
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All values were calculated comparing each patient's baseline levels to the reported values at the patient's 24-month visit. The Revised Venous Clinical Severity Score (rVCSS) is a clinically validated scoring system used to track the progression or regression of venous diseases. 'These interim two-year follow-up data demonstrate substantial and sustained improvement across all effectiveness endpoints at two years. This is extremely encouraging, especially when you consider that all the patients enrolled in the study had severe CVI and failed all other treatment options,' said Robert Berman, enVVeno Medical's Chief Executive Officer. 'Despite attempts over many decades, nobody has been able to create an effective treatment for severe CVI caused by malfunctioning valves in the deep veins of the leg. 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The Company has submitted a pre-market authorization (PMA) application for the VenoValve to the U.S. Food and Drug Administration (FDA), with a decision anticipated in the second half of 2025. Webcast Details The Company will host a webcast presentation to discuss the results for investors, analysts and other interested parties today, June 6, 2025, at 11:20 AM ET / 10:20 AM CT. Joining enVVeno management for the event will be Dr. Chaar. The live webcast will be accessible on the Events page of the enVVeno website, and will be archived for 90 days. About CVI Severe, deep venous Chronic Venous Insufficiency (CVI) is a debilitating disease that is most often caused by blood clots (deep vein thromboses or DVTs) in the deep veins of the leg. When valves inside of the veins of the leg fail, blood flows in the wrong direction and pools in the lower leg, causing pressure within the veins of the leg to increase (venous hypertension). Symptoms of severe CVI include leg swelling, pain, edema, and in the most severe cases, recurrent open sores known as venous ulcers. The disease can severely impact everyday functions such as sleeping, bathing, dressing, and walking, and is known to result in high rates of depression and anxiety. There are currently no effective treatments for severe CVI of the deep vein system caused by valvular incompetence. Estimates indicate that CVI costs the U.S. healthcare system in excess of $4 billion each year. About enVVeno Medical Corporation enVVeno Medical (NASDAQ:NVNO) is an Irvine, California-based, late clinical-stage medical device Company focused on the advancement of innovative bioprosthetic (tissue-based) solutions to improve the standard of care for the treatment of deep venous disease. The Company's lead product, the VenoValve®, is a first-in-class surgical replacement venous valve being developed for the treatment of deep venous Chronic Venous Insufficiency (CVI). The Company is also developing a non-surgical, transcatheter based replacement venous valve for the treatment of deep venous CVI called enVVe®. Both the VenoValve and enVVe are designed to act as one-way valves, to help assist in propelling blood up the leg, and back to the heart and lungs. The VenoValve is currently being evaluated in the VenoValve U.S. pivotal study and the Company is currently performing the final testing necessary to seek approval for the pivotal trial for enVVe. Cautionary Note on Forward-Looking Statements This press release and any statements of stockholders, directors, employees, representatives and partners of enVVeno Medical Corporation (the 'Company') related thereto contain, or may contain, among other things, certain 'forward-looking statements' within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements involve significant risks and uncertainties. Such statements may include, without limitation, statements identified by words such as 'projects,' 'may,' 'will,' 'could,' 'would,' 'should,' 'believes,' 'expects,' 'anticipates,' 'estimates,' 'intends,' 'plans,' 'potential' or similar expressions. These statements are based upon the current beliefs and expectations of the Company's management and are subject to significant risks and uncertainties, including those detailed in the Company's filings with the Securities and Exchange Commission. Actual results and timing (may differ significantly from those set forth or implied in the forward-looking statements. Forward-looking statements involve certain risks and uncertainties that are subject to change based on various factors (many of which are beyond the Company's control). The Company undertakes no obligation to publicly update any forward-looking statements, whether as a result of new information, future presentations or otherwise, except as required by applicable law. MEDIA CONTACT: Glenn Silver, FINN Partners (973) 818-8198 SOURCE: enVVeno Medical Corporation View the original press release on ACCESS Newswire
