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Verapamil/Calan


- See: 
- Class IV Agents 
- Discussion: 
- Ca channel blocker, prolongs AV conduction, slows sinus rate, & exerts Negative Inotropic effect; 
- Useful for converting narrow complex SVT to sinus rhythm in stable patients if carotid sinus massage unsuccesful; 
- Useful for Unstable Angina, HTN, A.fib & A. Flutter (except when A.fib/flutter is associatted with bypass tracts 
- see WPW 
- Will Not convert A.fib to normal sinus rhythym; 
- Not used for Ventricular arrhytmia; 
- Interactions: 
- may increase Digoxin levels by 50-75%;
- Cimetidine will reduce clearance (incr blood concentration) 
- contraindicated w/ use of Beta blockers, 2nd or 3rd AV block; 
- Acute Arrhythmia: 
- 5-10mg IV bolus (.075-.15mg/kg) over 2-3 min, w/ dose repeated q15-30 min as needed and tolerated; 
- Dosing for Adults
- 80 mg PO tid/qid initially; 
- Angina: 120-480mg/24hr in 3-4 divided doses; 
- Max dose: 480mg/day in patients with Angina
- HTN: 80mg PO tid or SR tab: 240 mg PO qd 


 
Verapamil enhances the survival of primary ischemic venous obstructed rodent skin flaps

Efficacy of verapamil in the salvage of failing random skin flaps.