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: Enalapril is a drug that is used for
treating high blood pressure. It is in a class of drugs called angiotensin
converting enzyme (ACE) inhibitors. ACE is an enzyme in the body that causes the
formation of angiotensin II. Angiotensin II causes the arteries in the body to
narrow, thereby elevating blood pressure. ACE inhibitors, such as enalapril,
lower blood pressure by preventing the formation of angiotensin II thereby
relaxing the arteries. ACE inhibitors also improve the effectiveness of the
heart in patients with heart failure by reducing the blood pressure that the
heart must maintain. Enalapril was approved by the FDA in December 1985.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Tablets: 2.5, 5, 10, and 20 mg.
Injection: 1.25 mg/mL
STORAGE: Tablets should be stored at room temperature between 15-30 C (59-86 F).
The injectable formulation should be stored at 20 to 25 C (68 to 77 F).
PRESCRIBED FOR: Enalapril is used alone or in combination with other
drugs to treat high blood pressure or congestive heart failure. After a
heart
attack, enalapril has been found to be effective in improving function of the
damaged heart and in reducing symptoms and hospitalizations related to heart
failure. The intravenous formulation is used when oral administration is not
possible.
DOSING: The usual oral dose for treating high blood pressure is 2.5-40
mg once daily. It may also be administered twice daily in two divided doses. The
dose for treating heart failure is 2.5-20 mg given twice daily. The usual
starting intravenous dose is 1.25 mg administered over a 5 minute period every 6
hours. If a patient is receiving diuretic therapy the initial intravenous dose
is 0.625 mg every 6 hours.
DRUG INTERACTIONS: Patients receiving diuretics may experience
excessive reduction in blood pressure when enalapril is started. Stopping the
diuretic or increasing salt intake prior to taking enalapril may prevent
excessive blood pressure reduction. Close supervision for at least 2 hours after
the start of enalapril and until blood pressure is stable is recommended if the
diuretic cannot be stopped.
Enalapril may increase potassium levels (hyperkalemia) in blood. Therefore,
there is an increased risk of hyperkalemia when enalapril is given with
potassium supplements or drugs that increase potassium levels (for example,
spironolactone [Aldactone]).
There have been reports of increased lithium (Eskalith, Lithobid) levels when
lithium is used in combination with ACE inhibitors. The reason for this
interaction is not known, but the increased levels may lead to toxicity from
lithium. There have been reports that
aspirin and other
nonsteroidal
anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's
Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin,
Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the
effects of ACE inhibitors.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
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.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Coronary atherosclerosis is the hardening and narrowing of
the arteries that supply blood to the heart muscle. Coronary atherosclerosis is
the major cause of heart attacks. Heart
attacks
are the major cause of sudden unexpected death
among otherwise healthy adults in the prime of their lives. Heart attacks are
also a significant cause of heart failure (due to weakened heart muscle) in this
country. Heart failure considerably decreases a person's longevity and quality
of life. In dollar terms, coronary heart disease is costly. The total cost of
coronary artery bypass surgery, coronary
angioplasty and stenting, medications,
and hospitalizations exceeds 50 billion dollars annually.
Coronary atherosclerosis, and hence heart attacks, are preventable. A person
can significantly lower his or her risk of heart attack by lowering
high blood
pressure, controlling diabetes, stopping
cigarett...
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