Posted By Kieran Beauchamp    On 6 May 2023    Comments (20)

The role of verapamil in pediatric care

Introduction to Verapamil

As a pediatric healthcare professional, it is important to stay up to date with the latest advancements in pharmacology. One such drug that has been making waves in pediatric care is verapamil, a calcium channel blocker commonly used in the treatment of various cardiovascular conditions. In this article, we will explore the role of verapamil in pediatric care, discussing its benefits, potential side effects, and contraindications. By the end of this article, you should have a better understanding of how verapamil can be integrated into your pediatric practice.

The Mechanism of Action of Verapamil

Before diving into the specifics of verapamil in pediatric care, it is essential to understand how the drug works. Verapamil is a calcium channel blocker, which means it inhibits the movement of calcium ions through cell membranes. Calcium ions play a crucial role in the contraction of smooth muscle cells, particularly in the heart and blood vessels. By blocking calcium channels, verapamil reduces the force of contraction in the heart and relaxes the blood vessels, leading to a decrease in blood pressure and a reduction in the heart's workload.

Benefits of Verapamil in Pediatric Care

Now that we have a basic understanding of how verapamil works, let's discuss some of the benefits this drug can offer in pediatric care. One of the primary uses of verapamil in children is the treatment of hypertension, or high blood pressure. Hypertension in children is a growing concern and has been linked to various long-term health complications, such as heart disease, kidney damage, and stroke. By helping to lower blood pressure, verapamil can reduce the risk of these complications and improve the overall health of pediatric patients.

Another potential benefit of verapamil in pediatric care is its ability to treat supraventricular tachycardia (SVT), a type of rapid heart rate that originates in the upper chambers of the heart. SVT can cause symptoms such as dizziness, shortness of breath, chest pain, and even loss of consciousness. Verapamil has proven effective in managing this condition by slowing down the heart rate and restoring a normal rhythm.

Potential Side Effects of Verapamil

As with any medication, it is important to be aware of the potential side effects associated with verapamil use in pediatric patients. Some common side effects include dizziness, headache, fatigue, constipation, and nausea. These side effects are generally mild and tend to resolve on their own with continued use of the medication. However, it is important to monitor patients closely and report any persistent or severe side effects to a physician.

There are also some more serious side effects that may occur with verapamil use, such as bradycardia (slow heart rate), hypotension (low blood pressure), and heart block. These side effects are relatively rare but can be potentially life-threatening if not promptly addressed. It is crucial to monitor pediatric patients closely for any signs of these serious side effects and to adjust the dose or discontinue the medication as necessary.

Contraindications and Precautions

While verapamil can offer many benefits in pediatric care, it is not appropriate for all patients. There are certain contraindications and precautions that healthcare providers should be aware of before prescribing verapamil to pediatric patients. Some contraindications include severe heart failure, second- or third-degree heart block, and severe hypotension. Additionally, verapamil should be used with caution in patients with liver or kidney impairment, as these conditions can affect the way the body metabolizes the drug.

It is also important to be aware of potential drug interactions when prescribing verapamil. This medication can interact with several other drugs, including beta-blockers, digoxin, and certain anti-arrhythmic medications. Therefore, it is essential to review a patient's medication history and discuss any potential interactions with a pharmacist or physician before prescribing verapamil.

Dosing and Administration

Proper dosing and administration of verapamil are crucial for ensuring its safety and effectiveness in pediatric patients. The dose of verapamil will depend on the patient's age, weight, and the specific condition being treated. Healthcare providers should consult the appropriate dosing guidelines and adjust the dose as necessary based on the patient's response and tolerance to the medication.

Verapamil is available in various forms, including immediate-release tablets, extended-release tablets, and injectable solutions. The appropriate form and route of administration will depend on the specific needs of the patient and the condition being treated. It is important to educate patients and caregivers on the proper administration of verapamil and to emphasize the importance of adherence to the prescribed regimen.

Monitoring and Follow-Up Care

Finally, it is crucial to closely monitor pediatric patients who are receiving verapamil therapy. Regular follow-up appointments should be scheduled to assess the patient's response to the medication, monitor for any side effects, and adjust the dose as needed. Blood pressure and heart rate should be monitored regularly, and additional testing, such as electrocardiograms or blood tests, may be necessary to evaluate the overall effectiveness of the treatment.

In conclusion, verapamil can play a valuable role in pediatric care, particularly in the management of hypertension and supraventricular tachycardia. By understanding the mechanism of action, benefits, potential side effects, contraindications, and proper dosing and administration of this medication, healthcare providers can effectively integrate verapamil into their pediatric practice and improve the overall health of their patients.

20 Comments

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    Lucinda Harrowell

    May 7, 2023 AT 19:33
    Interesting read. Verapamil's role in pediatric SVT is underdiscussed. I've seen it work wonders in teens with idiopathic arrhythmias - especially when adenosine fails. Still, the long-term cardiac remodeling data in kids is thin.
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    alex terzarede

    May 8, 2023 AT 04:30
    The dosing guidelines in pediatrics are a mess. Most are extrapolated from adult trials. We need more RCTs specific to kids - especially under 5. I’ve seen kids on verapamil with no side effects, and others who turned pale as a ghost after the first dose. It’s not one-size-fits-all.
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    maria norman

    May 9, 2023 AT 20:55
    Ah yes, the classic calcium channel blocker. The drug that makes cardiologists feel like wizards and parents feel like they’re raising a lab rat. Funny how we praise its "benefits" while quietly ignoring that half the kids on it are just... quiet. Too quiet.
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    Jasmine L

    May 10, 2023 AT 12:20
    I’ve used this in my clinic for SVT kids - works like a charm. But always pair it with a conversation about lifestyle. No amount of verapamil fixes a soda-and-screens diet 😅
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    Matt Czyzewski

    May 12, 2023 AT 01:59
    There's a metaphysical tension here - we pharmacologically tame the heart’s natural rhythm, yet call it healing. Is it control or coercion? Verapamil doesn't cure SVT; it silences its symphony. And who gets to decide which heartbeat is "normal"? The pediatrician? The insurance form? The algorithm?
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    John Schmidt

    May 13, 2023 AT 06:37
    Oh please. Verapamil? That’s just another Big Pharma puppet. You think they care about kids? They care about patent extensions. I’ve seen kids on this drug develop chronic fatigue so bad they couldn’t climb stairs. And the docs? They just write another script. Wake up.
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    Joe Rahme

    May 13, 2023 AT 22:53
    I’ve been on the receiving end of this debate - as a parent. My daughter was on verapamil for 18 months. We monitored her like a hawk. No major side effects. But I’ll never forget the first EKG showing sinus rhythm after months of SVT. That was the moment I stopped seeing meds as villains.
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    Melody Jiang

    May 14, 2023 AT 20:21
    It’s easy to focus on the drug, but the real magic is in the follow-up. The kid who gets weekly check-ins, the family that knows how to count pulses, the school nurse who’s trained - that’s the real treatment. Verapamil’s just the tool.
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    lisa zebastian

    May 16, 2023 AT 02:11
    They don’t tell you that verapamil is linked to autism rates in kids. It’s in the FDA’s hidden database. You think it’s coincidence? Millions of kids on calcium blockers since 2005. Coincidence? No. Cover-up.
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    Jo Sta

    May 17, 2023 AT 03:29
    America’s favorite pediatric drug. Next they’ll be giving kids statins for "pre-hypertension." We’re turning children into pharmaceutical test subjects. And you call this medicine?
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    April Barrow

    May 19, 2023 AT 01:09
    Verapamil dosing by weight is standard. But I’ve seen cases where a 10kg child got the same dose as a 30kg child because the chart was misprinted. Always double-check. Always.
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    Justice Ward

    May 20, 2023 AT 16:38
    I remember a 7-year-old who came in with SVT so severe she’d pass out during recess. After verapamil? She started playing soccer again. No drama. No fanfare. Just a kid who could breathe. That’s why we do this.
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    bhuvanesh kankani

    May 22, 2023 AT 10:57
    In India, we use verapamil for pediatric SVT too - but access is uneven. In rural clinics, we rely on it because amiodarone is too expensive. It’s not ideal, but it’s life-saving. We need global equity in pediatric pharmacology.
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    Jessie Bellen

    May 23, 2023 AT 16:11
    Verapamil? Sounds like a scam. Kids don’t need drugs. They need less sugar and more sleep.
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    Jasmine Kara

    May 24, 2023 AT 10:06
    My cousin was on this for years. He’s 22 now. Still takes it. No side effects. But he says he feels "off" sometimes. Like his heart’s not really his own. Idk. Just saying.
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    arthur ball

    May 24, 2023 AT 23:01
    You guys are overthinking this. Verapamil isn’t magic. It’s medicine. And when a kid’s heart is racing out of control? You don’t wait for yoga or chamomile. You give the drug. You save the life. Then you celebrate. Simple.
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    Harrison Dearing

    May 26, 2023 AT 18:19
    I’ve seen kids on verapamil become so lethargic they stopped talking. Parents think it’s "just side effects." But what if it’s depression? What if it’s the drug? We need to ask harder questions.
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    Dipali patel

    May 28, 2023 AT 03:24
    They’re using verapamil to control kids’ behavior. It’s not just for SVT. I’ve seen it prescribed for ADHD kids who "can’t sit still." The FDA knows. The CDC knows. They just don’t tell you. Look up the 2018 leaked memo.
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    Leia not 'your worship'

    May 29, 2023 AT 18:27
    I love how we treat kids like tiny adults. Give them adult doses. Watch them sleepwalk through puberty. Verapamil? Sure. Why not? We’ve already got them on ADHD meds, antidepressants, and melatonin. One more pill won’t hurt. Right? 😏
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    Richie Lasit

    May 30, 2023 AT 07:58
    To the parent who said their kid started playing soccer again - that’s why we do this. Not for the stats. Not for the papers. For that one kid who gets to be a kid again. Keep going.

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