Verapamil

Verapamil - a calcium-channel blocker that prolongs the refractory period of the AV node.

Uses
SVT
AF
Atrial flutter

Contraindications
Sinus bradycardia
Heart block
Congestive cardiac failure
VT/VF – may produce severe hypotension or cardiac arrest
WPW syndrome

Administration
• IV bolus: 5–10 mg over 2 min, may repeat with 5 mg after 10 min if required

Continuous ECG and BP monitoring
Decrease dose in liver disease and in the elderly

How not to use verapamil
Do not use in combination with B-blockers (bradycardia, heart failure, heart block, asystole)

Adverse effects
Bradycardia
Hypotension
Heart block
Asystole

Cautions
Sick sinus syndrome
Hypertrophic obstructive cardiomyopathy
Increased risk of toxicity from theophylline and digoxin

Organ failure
Hepatic: reduce dose