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Risk Factors:

Contraindications: PO: Acute MI pulmonary congestion hypersensitivity to diltiazem second- or third-degree AV block (except in presence of pacemaker) severe hypotension (less than 90 mm Hg systolic) sick sinus syndrome (except in presence of pacemaker). IV: Hypersensitivity to diltiaZEM. Sick sinus syndrome or second- or third-degree block (except with functioning pacemaker) cardiogenic shock administration of IV beta blocker within several hours atrial fibrillation/flutter associated with accessory bypass tract severe hypotension ventricular tachycardia.Pregnancy/Lactation: Distributed in breast milk. Children: No age-related precautions noted. Elderly: Age-related renal impairment may require dosage adjustment.

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Indications:

PO: Treatment of angina due to coronary artery spasm (Prinzmetal?s variant
angina) chronic sTabletle angina (effort-associated angina). Treatment of
hypertension. Parenteral: Temporary control of rapid ventricular rate in atrial
fibrillation/flutter. Rapid conversion of paroxysmal supraventricular tachycardia
(PSVT) to normal sinus rhythm.

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Adverse Effects:

Frequent (10%?5%): Peripheral edema dizziness light-headedness headache
bradycardia asthenia. Occasional (5%?2%): Nausea constipation flushing
EKG changes. Rare (less than 2%): Rash micturition disorder (polyuria
nocturia dysuria frequency of urination) abdominal discomfort drowsiness.
Adverse effects/toxic reactions
Abrupt withdrawal may increase frequency duration of angina HF; second- or
third-degree AV block occurs rarely. Overdose produces nausea drowsiness
confusion slurred speech profound bradycardia. Antidote: Glucagon insulin
drip with continuous calcium infusion

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Don’t Use:

Renal/hepatic impairment HF concurrent
use with beta blocker hypertrophic obstructive cardiomyopathy.