Verapamil and Diltiazem

Slows cardiac AV conduction directly by decreasing HR, contractility , BP and oxygen demand.
-ve ionotropic effect.
Extensively metabolized by liver and excreted through urine and feces.
Used to treat typical or variant angina, SVT and migraine headache.
 Should not be given in heart failure cases because of direct cardiac depression.
Increased digoxin level and should be used with great care.
It causes constipation due to smooth muscles relaxation and decrease peristalsis.

DIHYDROPYRIDINES
Having greater affinity for vascular CCB and due to that they are used in HTN.
Little interaction with digoxin.
Useful in treating variant angina due to vaso- spasm.
Do not suppress cardiac function.
Nimodipine is the only drug to treat sub- arachnoid heamorrhage .
Metabolized through liver and excreted by urine and feces.
Do not effect digoxine serum level significantly.