Which medication is NOT listed as part of the spasm-reducing cocktail for radial artery access?

• A. Verapamil
• B. Nitro
• C. Amlodipine
• D. Heparin

Answer: (C)

Radial artery spasm is best prevented with an intra-arterial cocktail that combines vasodilators to relax the vessel and an anticoagulant to keep the artery patent. Nitroglycerin provides rapid arterial dilation, and a calcium channel blocker like verapamil directly relaxes smooth muscle in the artery wall, helping prevent spasm during the procedure. Heparin serves as anticoagulation to reduce thrombus formation, which is also important during transradial access. Amlodipine, although a calcium channel blocker, is not used in this immediate intra-arterial spasm-relief mix because it has a slower onset and longer duration, making it less suitable for acute vasodilation during a radial procedure. Therefore, amlodipine is not part of the typical spasm-reducing cocktail.