Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Acebutolol is a drug that blocks receptors
(beta-adrenergic receptors) on nerves of the sympathetic nervous system that is
used to treat high blood pressure and ventricular
arrhythmias (abnormal rhythms
of the heart). Other beta-adrenergic agents within the same class as acebutolol
include, atenolol (Tenormin), betaxolol (Betoptic), celiprolol (Cardem),
bisoprolol (Zebeta), esmolol (Brevibloc), metoprolol (Lopressor, Toprol-XL), and
nebivolol (Bystolic). Acebutolol and other beta-adrenergic blocking drugs work
by blocking the action of the neurotransmitters, norepinephrine and epinephrine,
that nerves use to communicate with each other. Blocking the beta-1 adrenergic
receptors in the heart allows the heart to beat more slowly thereby reducing the
amount of blood that the heart must pump and, therefore, the work that the heart
must do and the amount of oxygen it must use. Over time, this action improves
the pumping of the heart.
Acebutolol and drugs within its class differ from
other beta-adrenergic blocking drugs because they are selective beta blockers,
that is, they block one type of beta-adrenergic receptor, the beta-l receptor,
rather than multiple types of beta-adrenergic receptors like other
beta-adrenergic blockers that are nonselective. This is especially important, in
patients with asthma or chronic obstructive pulmonary disease (COPD) who require
treatment with beta-adrenergic blocking drugs because blocking the non-beta-1
receptors can make asthma or COPD worse. Acebutolol was approved by the FDA in
December 1984.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 200 and 400 mg.
STORAGE: Capsules should be stored at room temperature, 77 F (25 C), away
from light and moisture.
PRESCRIBED FOR: Acebutolol is used alone or with other drugs to treat high
blood pressure and arrhythmias. It also is used to treat chest pain due to
coronary artery disease (angina) in which the supply of blood and oxygen to the
heart are inadequate for the heart to pump normally.
DOSING: Acebutolol can be taken with or without food, usually once or twice
daily. The dosage of acebutolol should be reduced in patients with dysfunction
of the kidneys or liver since kidney or liver disease reduce the elimination of
acebutolol.
DRUG INTERACTIONS: The use of beta-blockers together with fenoldopam
(Corlopam), a drug used to manage severe high blood pressure, may result in
unexpectedly low blood pressure since beta-adrenergic blocking drugs add to the
blood pressure-lowering effects of fenoldopam.
With concomitant use of clonidine (Catapres) and beta-adrenergic blocking
drugs, severe high blood pressure may occur if patients abruptly discontinue the
clonidine. Because of this effect, it is advisable to discontinue
beta-adrenergic blocking drugs prior to starting clonidine.
Using epinephrine (Adrenalin, EpiPen) and beta-adrenergic blocking drugs
together causes high blood pressure and a slow heartbeat since the
beta-adrenergic stimulating effects of epinephrine that raise blood pressure and
heart rate are exaggerated by the beta-adrenergic blocking drugs which prevent
dilation of the blood vessels and increase the heart rate. To avoid this effect,
it is best not to use both drugs together. If, however, both drugs are
administered together, it is important to monitor blood pressure levels. Also,
high blood pressure and a slow heartbeat are less likely to occur if
beta-adrenergic blocking drugs that are selective for the heart such as atenolol
(Tenormin) and acebutolol (Sectral) are used.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Chest pain is a common symptom that is caused by many different conditions. Some causes require prompt medical attention, such as angina,
heart attack, or tearing of the aorta. Other causes of chest pain that may not require immediate medical intervention include spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. An accurate diagnosis is important in providing proper treatment to patients with chest pain.
The diagnosis and treatment of angina is discussed below, as well as the diagnosis of other causes of chest pain that can mimic angina.
What is angina, and what are the symptoms of angina?
Angina (angina pectoris - Latin for squeezing of the chest) is chest discomfort
that occurs when there is a decreased blood oxygen supply to an area of the
heart muscle. In most cases, the lack of blood supply is due to a narrowing of
the coronary arteries as a result of arterioscler...
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