Which of the following is the action of Diltiazem?

Appeared in: DSSSB 14 August 2024

Explanation

Diltiazem is classified as a calcium channel blocker (CCB).
It works by blocking the influx of calcium ions into vascular smooth muscle and cardiac muscle cells.
This action leads to vasodilation (widening of blood vessels), which lowers blood pressure.
It also slows the heart rate and reduces the force of contraction, decreasing the workload on the heart.
Diltiazem is used to manage conditions like hypertension, angina, and certain arrhythmias.

Option A: Stimulants increase central nervous system and cardiovascular activity, causing effects like increased heart rate and blood pressure, which is the opposite of Diltiazem's action.
Option C: Beta-blockers (e.g., metoprolol, propranolol) work by blocking beta-adrenergic receptors. While they also lower heart rate and blood pressure, their mechanism is distinct from blocking calcium channels.
Option D: Sedatives and hypnotics are central nervous system depressants used to induce calmness or sleep. They do not primarily act on cardiac calcium channels to control heart rate or blood pressure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification and mechanism of action of Diltiazem as background academic context rather than a clinical decision trigger.
Nurses must monitor blood pressure and heart rate before and after administering Diltiazem. The dose should be held if the patient is hypotensive or bradycardic (e.g., heart rate below 60 bpm).
Patient education is crucial. Advise patients to change positions slowly to prevent orthostatic hypotension (dizziness upon standing) and to report any swelling in the ankles (peripheral edema), as these are common side effects.
Assess for signs of worsening heart failure, such as shortness of breath or rapid weight gain, as Diltiazem has a negative inotropic effect (decreases contraction force).

How to Approach the Question

First, identify the core of the question, which is asking for the pharmacological class or action of the drug 'Diltiazem'.
This is a factual recall question common in pharmacology.
Access your knowledge base of common cardiovascular medications.
Mentally categorize Diltiazem. Recall that it, along with drugs like verapamil and amlodipine, affects calcium channels.
Scan the options provided. Option B, 'Calcium channel blockers', directly matches this classification.
Briefly consider the other options to confirm they are incorrect. Stimulants, beta-blockers, and sedatives have distinctly different mechanisms and are not related to Diltiazem.

Concept Tested & Keywords

Concept Tested: Pharmacological classification and mechanism of action of Diltiazem.
Stem keywords: Diltiazem, action
Lead-in keywords: Which of the following

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 pp. 225-227, 223-225

E6 Pharmacology Katzung 16e p. 292-294

Practise the full DSSSB 14 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.