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.
BRAND NAMES: Cardizem, Dilacor, Tiazac and several others
DRUG CLASS AND MECHANISM: Diltiazem is a drug that is used for
treating heart pain (angina), high blood pressure, and abnormal heart rhythms.
It belongs to a class of drugs called calcium channel blockers (CCBs),
which includes amlodipine (Norvasc), verapamil (Calan, Isoptin), nifedipine (Adalat, Procardia) as well as others. CCBs block the entry of calcium into muscle cells that make up the
heart and that surround the arteries. It is the entry of calcium into these
cells that causes the cells to contract, allowing the heart to pump blood, and
the arteries to narrow. By blocking the entry of calcium, diltiazem decreases
the force of contraction of the heart and its rate of contraction. It also
relaxes the muscles surrounding the arteries, allowing the arteries to widen
(dilate). In order to pump blood, the heart needs oxygen. The harder the heart
works, the more oxygen it requires. Angina occurs when the supply of oxygen to
the heart is inadequate for the amount of work the heart must do. By dilating
arteries, diltiazem reduces the pressure in the arteries into which the heart
must pump blood, and, as a result, the heart needs to work less and requires
less oxygen. By reducing the heart's need for oxygen, diltiazem relieves or
prevents angina. Dilation of the arteries also reduces blood pressure. The FDA
approved diltiazem in 1982.
STORAGE: Tablets, capsules and powder for injection should be stored
at room temperature, 15-30 C (59-86 F). Solution for injection should be stored
at 2-8 C (36-46 F).
DOSING: Adult oral doses range between 120 and 480 mg daily. Immediate
release tablets are administered up to 4 times a day. Extended release
formulations are administered once daily at approximately the same time each day
and should not be crushed or chewed.
DRUG INTERACTIONS: Administration of diltiazem with digoxin
(Lanoxin) can
increase digoxin blood levels. Therefore, blood levels of digoxin usually are
monitored to avoid toxicity from digoxin. Similarly, concurrent administration
of diltiazem with an anti-seizure medication, carbamazepine (Tegretol), can
increase blood levels of the seizure medication, and occasionally lead to
toxicity. Diltiazem increases blood levels of lovastatin (Mevacor), atorvastatin
(Lipitor) and simvastatin (Zocor), possibly increasing the risk of adverse
effects. Diltiazem may increase blood levels of buspirone (Buspar),
midazolam
(Versed), triazolam (Halcion) and diazepam (Valium) by reducing their breakdown
and elimination from the body by the liver. This can lead to toxicity from these
drugs. Rifampin (Rifamate,
Rifadin,
Rimactane) reduces the effect of diltiazem by reducing its levels in blood
to undetectable levels.
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.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Mitral valve prolapse (MVP) is also also known as "click murmur syndrome" and "Barlow's syndrome." Mitral valve prolapse is the most common heart valve abnormality. Signs and symptoms of mitral valve prolapse include: fatigue, palpitations, chest pain, anxiety, and migraine headaches. Echocardiography is the most useful test for mitral valve prolapse. Most patients do not need any treatment, however, patients with severe prolapse may need treatment.
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.
Paroxysmal supraventricular tachycardia (PSVT) is an abnormal conduction of electricity in particular areas of the heart. PSVT was referred to at one time as paroxysmal atrial tachycardia or PAT, however, the term PAT is reserved for as specific heart condition. Symptoms of PSVT include weakness, shortness of breath, chest pressure, lightheadedness, and palpitations. PSVT is treated with medications or procedures that return the heart to its normal electrical pattern.
The heart is a two stage electric pump whose job it is to circulate blood through the body. There is a group of cells that serve as an automatic pacemaker located in the atrium that generates an electrical current that spreads to the heart muscle cells to generate a coordinated squeeze, so that the pump can function.
The heart has four chambers, the right and left atria (singular= atrium) and
the right and left ventricles. The right side of the heart pumps blood to the
lungs while the left side pumps it to the rest of the body.
Blood from the body is collected in the right atrium and is pushed into the
right ventricle with a small beat of the upper chamber of the heart. The right
ventricle then pumps the blood to the lungs to pick up oxygen. They oxygen-rich
blood returns to the left atrium where the small atrial beat
pushes it to the left ventricle. The left ventricle is much thicker than the
right because it needs t...
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