Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
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: Bisoprolol belongs to a class of drugs called
beta-adrenergic receptor blocking agents that also includes propranolol
(Inderal), atenolol (Tenormin), and timolol (Blocadren). Bisoprolol is used for
treating high blood pressure and heart pain (angina). Bisoprolol prevents the
neurotransmitters (chemicals that nerves use to communicate with other nerves),
norepinephrine and epinephrine (adrenaline), from binding to beta receptors on
nerves. By blocking the effect of norepinephrine and epinephrine on the nerves
reaching the heart and blood vessels, beta blockers reduce heart rate and the
force with which the heart contracts and reduce blood pressure by dilating blood
vessels but may constrict air passages by stimulating the muscles that surround
the air passages. Angina occurs when the heart's need for oxygen exceeds the
supply of oxygen-carrying blood. By slowing heart rate and decreasing the force
with which the heart muscle contracts, bisoprolol reduces the work of the heart
and the demand of the heart for oxygen. The FDA approved bisoprolol in July
1992.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 5 and 10 mg.
STORAGE: Bisoprolol should be stored at room temperature, 59-86 F (15-30 C)
in an air-tight container.
PRESCRIBED FOR: Bisoprolol is used alone or with other drugs for treating
patients with high blood pressure. It also is used for treating angina and
congestive heart failure.
DOSING: The usual adult dose of bisoprolol is 2.5-20 mg once daily.
DRUG INTERACTIONS: Rifampin may increase the metabolism (destruction) of
bisoprolol, possibly making bisoprolol less effective. Certain
calcium channel
blockers, especially verapamil (Calan, Isoptin) and diltiazem (Cardizem,
Tiazac), may enhance the effect of bisoprolol on the heart. In some patients,
this may cause excessive slowing of the heart rate or reduce the heart's ability
to beat. The use of digoxin (Lanoxin) with bisoprolol also may cause an
excessive reduction in heart rate.
PREGNANCY: There are no adequate studies in
pregnant women.
NURSING MOTHERS: It is not known if bisoprolol is secreted in
breast milk.
SIDE EFFECTS: Bisoprolol is generally well-tolerated, and side effects are
mild and transient. Side effects include abdominal cramps, diarrhea, dizziness,
fatigue, depression, headache, nausea, impotence, slow heart rate,
low blood
pressure, numbness, tingling, cold extremities, sore throat, and shortness of
breath or wheezing.
Bisoprolol can aggravate breathing difficulties in patients with
asthma, or
chronic bronchitis and emphysema that have a component of bronchial spasm. In
patients with existing slow heart rates (bradycardias) and heart blocks (defects
in the electrical conduction within the heart), bisoprolol can cause dangerously
slow heart rates and even shock. Bisoprolol reduces the force of contraction of
heart muscle and can aggravate symptoms of heart failure. In patients with
coronary artery disease, abruptly stopping bisoprolol can suddenly worsen angina
and occasionally cause heart attacks. If it is necessary to discontinue
bisoprolol, its dosage can be reduced gradually over one to two weeks.
Bisoprolol can mask the early warning symptoms of low blood sugar
(hypoglycemia), and should be used with caution in patients receiving treatment
for diabetes.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
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.
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.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs.
Many disease processes can impair the pumping efficiency of the heart to cause
congestive heart failure.
The symptoms of congestive heart failure vary, but can include fatigue, diminished exercise capacity, shortness of breath, and swelling.
The diagnosis of congestive heart failure is based on knowledge of the
individual's medical history, a careful physical examination, and selected laboratory tests.
The treatment of congestive heart failure can include lifestyle modifications, addressing potentially reversible factors, medications, heart transplant, and mechanical therapies.
The course of congestive heart failure in any given patient is extremely variable.
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