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: Nadolol is a member of a class of drugs
called beta-adrenergic receptor blockers that is used for treating high blood
pressure and heart pain (angina). Examples of other beta-adrenergic blockers
include propanolol (Inderal,
Inderal LA), atenolol (Tenormin), and timolol (Blocadren).
Norepinephrine and epinephrine (adrenaline) are chemicals released within the
body that attach to receptors on several types of cells, including nerves and
some muscles, and changes the way the cells function, either stimulating the
cells or suppressing them. Nadolol prevents norepinephrine and epinephrine from
binding to beta receptors on nerves. By blocking the effect of norepinephrine
and epinephrine, beta blockers reduce heart rate, reduce the force of the
heart's contractions, and reduce blood pressure by relaxing the muscles
surrounding the blood vessels.
Heart pain (angina) occurs when the workload of
the heart requires more oxygen than the blood can supply. By slowing the heart
rate and decreasing the force of contractions of the heart, nadolol reduces the
demand of the heart's muscle for oxygen and thereby prevents angina. Beta
blockers may cause difficulty breathing since they cause the muscles surrounding
the air passages of the lung to contract, narrowing the air passages and making
it more difficult for air to pass through them. The FDA approved nadolol in
1979.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 20, 40, 80, 120,160 mg.
STORAGE: Nadolol should be stored at room temperature, 15-30 C
(59-86 F).
DOSING: The recommended dose is 40-320 mg once daily. The maximum dose
for treating angina is 240 mg daily and for hypertension is 320 mg daily.
Nadolol may be administered with or without food.
DRUG INTERACTIONS: The blood pressure-lowering effects of nadolol are
additive with other medications that lower blood pressure, and combinations of
these other medications with nadolol often is used for treating persons with
high blood pressure. When used in combination with diltiazem (Cardizem; Tiazac;
Dilacor), verapamil (Calan, Isoptin, Verelan, Covera), amiodarone (Cordarone),
or digoxin (Lanoxin), however, nadolol can cause complete block of the heart's
electrical system, a life-threatening condition.
Nadolol can mask the early warning symptoms of low blood sugar (hypoglycemia)
and should be used with caution in patients receiving treatment for diabetes.
PREGNANCY: Safe use of nadolol during
pregnancy has not been
established.
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.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
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.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
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.
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.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
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.
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.
Stress is simply a fact of nature -- forces from the inside or outside world affecting the individual. The individual responds to stress in ways that affect the individual as well as their environment. Because of the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience.
In general, stress is related to both external and internal factors. External factors include the physical environment, including your job, your relationships with others, your home, and all the situations, challenges, difficulties, and expectations you're confronted with on a daily basis. Internal factors determine your body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your nutritional status, overall health and fitness levels, emotional w...
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