Is it possible to medicate CHF client with CCB with glycoside maintaince? Is there a drug-drug interaction?.?

Answer 1

To translate, CCB=calcium channel blocker, glycoside = digitalis (I think).

To answer, it depends on the severity of the CHF. In the US, th combination isn't the usual treatment. I'd expect : beta blocker, ACE inhibitor, diuretic.

Having said that, treatment should be individualized. Both of the meds you listed can lower the heart rate. This would be the biggest interaction. Once the doses are stabilized, then they can be safe.

Talk with your doctor.

Answer 2

Yes, these two medications can be used together under certain circumstances for patients with CHF

Digitalis binds to the sodium pump on the myocardial cell membrane and inhibits its function. This pump when inhibited causes a rise in the amount of sodium inside the heart cell, which then exchanges it for calcium through the cell membrane, as calcium rises inside the heart cell contractile mechanism becomes more optimal and stronger.

Affects of CCB's are as follows:
1. Peripheral vasodilatation
2. Negative chronotropy (decreased heart rate)
3. Negative inotropy (decreased cardiac contractility)
4. Negative dromotropy (decreased cardiac conduction)
(from the benzothiazepine class [example diltizem], mostly; dihydropyridine class [example Norvasc] of CCB usually do not have this affect)

So in sum

1. CCB reduces contractility and Digitalis increases contractility, thereby working against each other.
2. Certain classes of CCB are heart rate reduction medications and this can be exacerbated by digitalis.
3. CCB can prompt peripheral edema which can be a concern in CHF.

Despite the above, CCB's are still commonly used with CHF patients, with and without digitalis. Rationale for considering them both is important. Low doses and close monitoring is the rule when adding medications initially - especially in elderly patients.

I hope this helps. Good luck.