deltm and Verapamil are medications that belong to the drug class of calcium channel blockers in this pneumonic video we'll cover the important facts about deltm and Verapamil so you'll be ready come test day in this Australian airport the Delta members get exclusive access to the Delta Zen Lounge which Prides itself on providing a relaxing stress-free environment for its guests Delta Zen will serve as your memory anchor to the drug delm Delta Zen Ben for D tym okay A woman decided to treat herself to some ice cream while she waited for her plane to begin boarding while the ice cream was being prepared she picked up a tourist pamphlet and became so engrossed in it that she didn't notice her pet vipers growing hungry the bag of food she normally uses to feed her vipers is resting on top of her snake crate looking closely the snake food is labeled Viper meal since it literally contains meals for viper snakes use the Viper meal to help you remember the drug name Verapamil delm and Verapamil belong to the same drug class so let's move on to learn more about that the symbols related to the drug class are grouped here in the middle of the scene the ice cream served by this stand is no ordinary ice cream it's the world famous calcium brand ice cream to consistently serve the perfect scoop the ice cream passes through a special ice cream shoot here at Pixar eyes we use calcium ice cream as our symbol for calcium because ice cream has a lot of calcium right so a calcium ice cream Chute symbolizes calcium channels since channels move things from one place to another just like they shoot because the woman didn't feed her hungry vipers the snakes escaped their crate and slithered into the airport in search of food the ice cream worker caught a glimpse of the escaping snakes causing him to panic he quickly closed the door to the ice cream shoot in order to run away from the snakes you could even say he's blocking the Chute this symbolizes how deltm and Verapamil block calcium channels in other words they are calcium channel blockers calcium channels regulate the flow of calcium ions into cells particularly in cardiac and smooth muscle cells the movement of calcium plays a crucial role in muscle contraction nerve signaling and other cellular functions like their name suggest calcium channel blockers block these calcium channels we'll talk more about the mechanism in a minute but first let's talk about another classification for these drugs the pamphlet the woman is reading is advertising an exciting Excursion tourists can book involving driving big four-wheel drive trucks into the Australian Outback these four-wheel drive trucks are also called 4x4s before being allowed to take the trucks into the back country participants are required to complete a 4x4 class to learn proper truck driving techniques use the 4x4 class to help help you remember that deltm and Verapamil are class 4 anti-arrhythmics meaning they are used to treat abnormal heart rhythms the anti- arthic are divided into different classes class 4 anti- arthic work by targeting the calcium channels in the heart next let's dive a little deeper into how these drugs work inside the body we've grouped the symbols related to the mechanism of delm and Verapamil in the top right corner of the scene inside the airport lounge in the past the airport lounge featured two water pyramids known around here as the die Hydro pyramids die because there's two of them and hydro because they're filled with water the dihydro pyramids should remind you of dihydro purines however the dihydro pyramids have recently been removed and a different water feature is being installed in their place a sign has been posted to inform visitors that the die hydrop pyramids are no longer present the no di hydrop pyramid sign is here to help you remember that deltm and Verapamil are classified as non di hydrop purines calcium channel blockers can be separated into two types the dihydro purines and the non dihydro purines we cover the DI hydropen in a separate video DM and Verapamil however are non dihydropterin and they are mainly used as anti-arrhythmics to get the new water display up and running a worker is filling up the fountain using a hose take a look at how he's stretching the end of the hose over a faucet you could even say he's dilating the hose right and doesn't this red hose kind of remind you of a blood vessel the way he is dilating this vessel like hose represents how deltm and Verapamil dilate blood vessels in the body in other words they act as vasod dilators delm and Verapamil achieve this vasod dilating effect by blocking the calcium channels we mentioned earlier this causes the smooth muscle cells inside the walls of blood vessels to relax leading to widening of the vessels the final touch on the new water display is adding a big heart-shaped Turtle take a look at it swimming slowly through the water this slow heart-shaped Turtle should help you remember that these calcium channel blockers slow the heart rate by blocking calcium channels deltm and Verapamil reduce the amount of calcium entering the heart cells during each heartbeat one effect of this decreased calcium concentration is a slow heart rate the Delta Zen an employee is dressed up as a heart to show Delta's love for its guests however instead of helping customers this employee is working out using the gym equipment in the lounge because he's wearing a big heart costume this employee is feeling weak and is struggling to contract his muscles and lift the weights just like this weak heart is unable to contract the weight deltm and Verapamil weaken heart contractions since calcium is necessary for muscle contractions by blocking calcium channels in the heart deltm and Verapamil decrease calcium levels and weaken the heart's ability to contract in the Delta Zen Lounge there's an intercom system that's used for playing music and making announcements this system is managed through an audiovisual soundboard often referred to as the AV board like many things in this Lounge the AV board is heart-shaped to show Delta's love for its guests attached to the AV board is a sticky note reminding the worker about an upcoming announcement that he need needs to make once he finishes his workout you might even call the note on the AV board an AV note the AV note is our recurring symbol for the AV node also known as the atrio ventricular node just like the conducting wires here connect the top and bottom of the heart-shaped soundboard the AV node acts as a bridge to conduct electrical impulses from The upper chambers of the heart called the Atria to the lower chambers of the heart called the ventricles given the abundance of bugs in the Australian Outback it's not surprising that a snail has made its way into the airport the snail is slowly crawling across the conducting wire next to the note this slow snail on the conducting wires at the AV note should help you remember how these drugs slow conduction through the AV node if it helps we've also drawn the Slime of the snail damaging the wire as an additional way to show how conduction at the AV node is slowed calcium channel blockers slow down the movement of of electrical signals between the Atria and the ventricles next let's talk about when deltm and Verapamil might be prescribed we've grouped the symbols related to their clinical use on the left side of the scene the machine scanning the luggage is malfunctioning with static running across its screen looking closer doesn't the static on the screen kind of remind you of an arhythmia on a cardiac monitor here at pixiz we use arhythmia like static to symbolize arhythmia a broad term that describes Des cries any irregular heart rhythms a maintenance man was called to fix the static on the broken machine which can remind you that these calcium channel blockers are used to fix or treat arrhythmias in other words they are anti-arrhythmics our next symbols will help us remember exactly which type of arhythmia deltm and Verapamil treat because the machine is broken TSA security agents are manually inspecting all the luggage in one particular suitcase they discover it was packed with a t-shirt featuring the Soviet Union symbol you could even call it a Soviet T use this Soviet T to remind you of SBT since Soviet T contains the letters SBT right SBT stands for super ventricular tacac cardia Supra means above ventricular refers to the ventricles and tacac cardia means a fast heart rate putting these together supraventricular tacac cardia refers to fast heart rhythms that originate above the ventricles next take a look at how the Soviet te is located next to the screen with a rhythmia likee static this should remind you that SVT is a type of arhythmia so the repair man fixing the static by this Soviet T represents how delm and Verapamil treat SVT as we covered earlier deltm and Verapamil block calcium channels leading to a slower heart rate and slower electrical conduction through the AV node both of these mechanisms help to treat SVT suspecting the individual might be a security threat the security agents detained him and put him into a lie detector to question him about his travel intentions however the lie detector machine is malfunctioning incorrectly marking everything the man says as a fib meaning a lie the phrase a fib should remind you of well aib which is short for atrial fibrillation in apib the heart's upper chambers called the Atria experienced chaotic electrical signals causing them to quiver or fibrillate instead of Contracting effectively this causes blood to pull in the Atria instead of flowing like it should through the ventricles and out to the rest of the body on a rhythm strip this looks like an irregular and rapid heartbeat similar to the line on the lie detector since the maintenance worker is already here fixing the luggage scanner he is also going to repair the lie detector machine the fixing of the apib machine should help you remember how deltm and and Verapamil treat apib as we discussed earlier blocking calcium channels slows conduction in the AV node and slows down the heart rate both of these mechanisms can help treat apib meanwhile the woman's vipers are slithering through the airport causing chaos the first one made its way to the airport's Atrium a spacious area bathed in natural sunlight and in this case fluttering butterflies it's understandable why the hungry snake was drawn to the atrium given that snakes enjoy basking in the warm sun and eating insects use the atrium to help you remember the Atria meaning the upper chambers of the heart we've even put a heart display at the top of the atrium to help you remember the Atria are at the top of the heart next use the fluttering butterflies to help you remember atrial flutter atrial flutter is another type of arhythmia that involves unusually fast regular atrial contractions an employee is now actively catching and removing the precious butter flies from The Atrium hoping to protect them from the hungry snake the way he is removing the fluttering Butterflies from The Atrium should help you remember that DM and Verapamil remove or treat atrial flutter once again blocking the calcium channels in the heart can slow the electrical conduction through the AV node and slow down the heart rate which can treat atrial flutter in summary deltm and Verapamil slow down abnormally fast arrhythmias including SV apib and atrial flutter an elderly man was relaxing in the atrium when he spotted the snake causing him to get scared and experience a sudden episode of chest pain luckily he always brings his medication when traveling in case something like this happens the way the man is treating his chest pain can help you remember that Dam and Verapamil are also used to treat chest pain also called angina in addition they are used in the treatment of heart attacks also called myocardial in factions if it helps you can remember that the man is wearing an ihart MI shirt he's here in Australia on vacation but he's actually from Michigan which is abbreviated Mi similarly myocardial infarctions are abbreviated Mi angin is caused by insufficient blood flow to the heart and severe forms of angina can turn into Mis essentially the heart is demanding more oxygen than its blood vessels can supply earlier we talked about how these drugs cause phas dilation by dilating the coronary arteries deltm and Verapamil increase the blood flow to the cardiac muscle this is one of the ways that these drugs treat angina and Mis being a crowded public place the airport Atrium is equipped with a first aid kit in case of emergencies mistaking it for food the Viper bit into the blood pressure cuff causing it to deflate here at Pixar eyes we use a blood pressure cuff to symbolize well blood pressure and the way the blood pressure cuff is now deflating or losing pressure can help you remember that calcium channel blockers are also used to lower blood pressure this makes them useful in treating blood pressure that's too high a condition known as hypertension calcium channel blockers lower blood pressure through the vasod dilation we talked about earlier think about it this way a wider blood vessel caused by vasod dilation means blood can flow through without putting as much pressure against the vessel walls hence wider vessels leads to to lower blood pressure calcium channel blockers are often prescribed to patients who have hypertension with a goal of lowering their blood pressure to a healthy level next let's talk about some side effects that can occur after administering deltm and Verapamil these symbols are grouped together in the bottom right of the scene inside the airport bathroom first let's return to the deflating blood pressure cuff which you already know symbolizes how the drugs lower blood pressure while lowering blood pressure is a good thing when treating hypertension it's actually possible to go too far and lower blood pressure too much this can result in abnormally low blood pressure a state called hypotension it's therefore important to monitor the patient's blood pressure and keep hypotension in mind as a potential side effect of calcium channel blockers the bathroom next to the Delta Zen Lounge entrance is a hi traffic area people in airports are always using the bathroom before boarding their plane resulting in a clogged toilet just like this toilet is backed up deltm and Verapamil can cause the intestines to back up in other words they cause constipation in addition to blocking calcium channels in the heart and blood vessels these medications block calcium channels in the GI tract this slows the movement of food through the intestines which can result in constipation as the nurse teach your patients taking delm or Verapamil that constipation is a common expected side effect that may be prevented by increasing fluids and fiber in the diet this clown is wearing water balloon pants that she fills up with water she knows she looks dumb but she's hoping they will get her some extra laughs the way these pants are swollen with water can help you remember that these drugs can cause edema edema is just a fancy word for swelling caused by fluid trapped in body tissues which usually affects the lower extremities like the legs and the feet as the nurse teach your patients taking these medications to watch for signs of Edema such as swelling in the lower extremities we already know how much Delta loves to decorate with hearts to show its love for its guests they've even requested the clown to perform a juggling act using their signature heart-shaped blocks as she fills the water pants the clown places the heart blocks on the bathroom counter use these heart blocks to help you remember that DTM and Verapamil can cause heart block as a side effect in heart block electrical signals from the Atria are delayed or blocked as they travel down the AV node to reach the ventricles we already talked about how DM and Verapamil slow the conduction through the AV node and if it slows too much it can lead to the side effect of heart block this can potentially lead to symptoms such as dizziness fatigue or fainting the Clown's pants take a while to fill so in the meantime she sprayed herself with her favorite heart-shaped perfume pump this heart-shaped pump is our symbol for the heart since has a heart shape and the Heart can be thought of like a pump since it pumps blood right drawn to the brightly colored clothes a snake slithered into the bathroom and bit the clown in her shock the clown dropped her perfume causing it to break you could even say this broken heart-shaped pump has failed which is why it's our symbol for heart failure deltm and Verapamil have the potential to cause heart failure heart failure occurs when the heart fails to pump blood forward as well as it should just like how this broken pump pum is now unable to pump perfume we mentioned earlier how delm and Verapamil weaken the heart's contractions and this ultimately contributes to heart failure for this reason these medications should be used very cautiously in patients who already have heart failure the clown immediately started feeling symptoms of the Venom starting off with dizziness which reminds me deltm and Verapamil can cause dizziness as a side effect this dizziness is often caused by a sudden drop blood pressure that occurs when the patient changes positions too quickly the medical term for this is orthostatic hypotension teach your patients taking calcium channel blockers to change positions slowly to avoid dizziness and Falls returning to the clown she also started experiencing a headache from the Viper Venom use the Clown's headache to help you remember that deltm and Verapamil can cause headache inform your patients that a headache is something they may experience and if it becomes a persistent problem a change in dosage or medication may be required one last side effect actually has to do with the slow turtle that we talked about earlier which you already know symbolizes a slow heart rate deltm and Verapamil are used to slow down the heart rate but it's possible to slow the heart rate too much this can lead to a condition called Brady cardia meaning an abnormally slow heart rate for this reason it's important to monitor the patient's heart rate throughout treatment and Report Brady cardia to the patient's healthcare provider finally there's one important nursing consideration that you need to know this symbol is on the far left of the scene back by the airport security there's a sign in front of the TSA security saying that grapefruit juice isn't allowed to go through security no liquids go through security and that includes grapefruit juice this no grapefruit juice sign should help you remember that patients taking calcium channel blockers should avoid drinking grapefruit juice grapefruit juice interferes with the metabolism of deltm and Verapamil and if the drug isn't being metabolized levels can quickly build up in the bloodstream increasing the risk of developing side effects long story short warn your patients taking calcium channel blockers to avoid grapefruit juice all right that's all for this demonic let's recap delam and Verapamil are calcium channel blockers that are classified as class 4 antiarrhythmics these drugs specific iic Al act as non di hydrop purine calcium channel blockers they work in the body by causing baso dilation and slowing down the heart rate they also weaken the heart's contractions and slow the electrical conduction through the AV node as anti-ar arhythmic these drugs are useful in treating arrhythmias with abnormally fast rhythms such as SVT apib and atrial flutter they can also be used to treat angina and myocardial infarctions as well as hypertension side effects of DM and Verapamil include hypotension constipation and edema they can also lead to cardiac complications such as heart block and heart failure other side effects to watch for include dizziness headaches and Brady cardia patients taking calcium channel blockers should avoid grapefruit juice and now we're actually done with deltm and Verapamil see you next time