A calcium channel blocking drug, used as a coronary vasodilator and antiarrhythmic.

Pharmacologic action: Calcium channel blockade, direct, potent negative chronotrope and inotrope, slows conduction in AV node, systemic and coronary vasodilation.

Uses: Supraventricular tachycardias.

Dose: 2.5 - 5.0 mg IV over 1-2 minutes May repeat at 5.0 - 10 mg every 15-30 minutes until 30 mg total dose.

Onset: 3 - 5 min.

Potential complications: Hypotension due to vasodilation and depressed contractility. Treat with calcium; bradycardia, AV block can be exacerbated, contraindicated with congestive heart failure, synergistic interaction with beta blockers.

Note: Administration of verapamil to a patient with ventricular tachycardia can be lethal. Verapamil can accelerate heart rate and decrease blood pressure, especially in patients with Wolff-Parkinson-White and wide-complex tachycardia.

(12 Mar 2000)

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