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: Fosinopril is in a class of drugs called
angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are used for
treating high blood pressure, heart failure and for preventing
kidney failure
due to high blood pressure and
diabetes. Other ACE inhibitors include enalapril
(Vasotec), quinapril (Accupril), captopril (Capoten), ramipril (Altace),
benazepril (Lotensin), lisinopril (Zestril, Prinivil), moexipril (Univasc) and
trandolapril (Mavik). ACE is an enzyme in blood which controls the formation of
angiotensin II, a chemical that circulates in blood and causes constriction of
arteries and veins. Constriction of arteries and veins elevates blood pressure.
ACE inhibitors inhibit ACE and block the formation of angiotensin II. By
blocking the formation of angiotensin II, fosinopril relaxes the arteries and
veins and lowers blood pressure. By reducing blood pressure, fosinopril also
reduces the work that the heart must do to pump blood through the arteries and
veins. This improves the output of blood from the heart. The FDA approved
fosinopril in May 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 20, and 40 mg
STORAGE: Tablets should be stored between 15 and 30 C (59- 86 F).
PRESCRIBED FOR: Fosinopril is used for treating high blood pressure. Its
blood pressure lowering effect can be further enhanced by adding a diuretic
medication ("water pill") such as hydrochlorothiazide. Fosinopril also is used
for the treatment of congestive heart failure, a condition in which the heart is
not able to pump enough blood and fluid collects within the body. In patients
with congestive heart failure, the ACE inhibitor class of medications has been
shown to reduce symptoms and hospitalization and to improve survival. After a
heart attack, ACE inhibitors improve the function of the damaged heart and
reduce symptoms and hospitalizations due to congestive heart failure.
DOSING: The recommended adult dose for treating hypertension or heart failure
is 10-40 mg once or twice daily. The maximum dose is 80 mg daily. Fosinopril is
generally prescribed once daily, although some patients may need two doses per
day. Patients with reduced kidney function need lower doses since their kidneys
do not eliminate fosinopril from the body as well as normal kidneys. Fosinopril
may be taken with or without food.
DRUG INTERACTIONS: Combining fosinopril with potassium supplements, potassium
containing salt substitutes, or potassium-conserving diuretics such as amiloride
(Moduretic), spironolactone (Aldactone), and
triamterene (Dyazide, Maxzide), can
lead to dangerously high blood levels of potassium (hyperkalemia) since fosinopril has a
tendency to reduce the excretion of potassium.
Fosinopril should not be taken at the same time as aluminum or
magnesium-based antacids, such as
simethicone (Mylanta, Gas-X, etc.) or Maalox since these antacids
decrease the amount of fosinopril that is absorbed from the intestine. Patients
should take antacids and fosinopril at least two hours apart.
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.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
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.
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
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.
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.
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
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.
The major goal in treating diabetes is to minimize any elevation of blood
sugar (glucose) without causing abnormally low levels of blood sugar. Type 1
diabetes is treated with insulin, exercise, and a
diabetic diet. Type 2 diabetes
is treated first with weight reduction, a diabetic diet, and exercise. When
these measures fail to control the elevated blood sugars, oral medications are
used. If oral medications are still insufficient, treatment with insulin is
considered.
Adherence to a diabetic diet is an important aspect of controlling elevated
blood sugar in patients with diabetes. The American Diabetes Association (ADA)
has provided guidelines for a diabetic diet. The ADA diet is a balanced,
nutritious diet that is low in fat, cholesterol, and simple sugars. The total
daily calories are evenly divided into three meals. In the past two years, the
ADA has lifted the absolute ban on simple sugars. Small amounts of si...
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