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.
Diuretic-induced [for example, by furosemide
(Lasix)] reduction in blood potassium or
magnesium levels may predispose patients to digoxin-induced abnormal heart
rhythms.
Saquinavir (Invirase) and ritonavir (Norvir) increase the amount of digoxin
in the body and may cause digoxin toxicity.
PREGNANCY: There are no
adequate studies in pregnant women.
NURSING MOTHERS: Digoxin in
secreted in breast milk at concentrations similar to concentrations in the
mothers blood. However, the total amount of digoxin that will be absorbed from
breast milk by the infant may not be enough
to cause effects. Caution should be exercised by nursing mothers who are taking
digoxin.
SIDE EFFECTS: Common side
effects include nausea,
vomiting, headache, dizziness, skin rash, and mental
changes. Many digoxin side effects are dose dependent and happen when blood
levels are over the narrow therapeutic range.
Therefore, digoxin side effects can be avoided by keeping blood levels within
the therapeutic level. Serious side effects associated with digoxin include
heart block, rapid
heartbeat, and slow heart rate. Digoxin has also been associated with visual
disturbance (blurred or yellow vision), abdominal pain,
and breast enlargement. Patients with low blood potassium levels can develop
digoxin toxicity even when digoxin levels are not considered elevated.
Similarly, high calcium and low magnesium blood levels can increase digoxin
toxicity and produce serious disturbances in heart rhythm.
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.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
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.
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
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 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.
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