Pines and non-pines of CCBs

Q: Which class of calcium channel blockers (CCBs) may help reduce proteinuria? - select one

A) dihydropyridines

B) Non-dihydropyridines

Answer: B

Knowing the difference between the two major classes of CCBs is essential.

1. Dihydropyridines
2. Non-dihydropyridines 

The dihydropyridines are known to have negligible or no adverse effect on cardiac contractility or conduction. They are used to treat hypertension or chronic stable angina via a vasodilatory mechanism. This class includes

• nifedipine
• isradipine
• felodipine
• nicardipine
• nisoldipine
• lacidipine
• amlodipine

The non-dihydropyridines reduce proteinuria and are typically used for hypertension, chronic stable angina, and cardiac arrhythmias. They are not as potent vasodilators as the above group and have a depressive effect on cardiac conduction and contractility. This class includes:

• verapamil 
• diltiazem

#pharmacology

#cardiology

#nephrology

References:

1. McKeever RG, Patel P, Hamilton RJ. Calcium Channel Blockers. 2024 Feb 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29494080.

2. Zhu J, Chen N, Zhou M, Guo J, Zhu C, Zhou J, Ma M, He L. Calcium channel blockers versus other classes of drugs for hypertension. Cochrane Database Syst Rev. 2022 Jan 9;1(1):CD003654. doi: 10.1002/14651858.CD003654.pub6. PMID: 35000192; PMCID: PMC8742884.

3. McKeever RG, Patel P, Hamilton RJ. Calcium Channel Blockers. [Updated 2024 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482473/