Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
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: Nifedipine belongs to a class of medications called
calcium channel blockers (CCBs) that are used to treat angina (heart pain),
high
blood pressure, and abnormal heart rhythms. Other drugs in the same class
include amlodipine (Norvasc), diltiazem (Cardizem LA, Tiazac), felodipine
(Plendil), isradipine (Dynacirc), nicardipine (Cardene),
nimodipine (Nimotop),
and verapamil (Covera-HS, Veralan PM, Calan). Like other CCBs, nifedipine works
by blocking the flow of calcium into the muscle cells surrounding the arteries
that supply blood to the heart (coronary arteries) as well as other arteries of
the body. Since the inflow of calcium is what causes the muscle cells to
contract, blocking the entry of calcium relaxes the muscles and dilates (widens)
the arteries. By dilating coronary arteries, nifedipine increases the flow of
blood to the heart. This treats and prevents angina which occurs when the flow
of blood to the heart is not adequate to supply the heart with enough oxygen
necessary to pump blood. Relaxing the muscles surrounding other
arteries of the body lowers blood pressure and thereby reduces the pressure
against which the heart must pump blood and function.
This reduces the demand of the heart for oxygen--another mechanism by which CCBs
treat and prevent angina. In addition, nifedipine slows conduction of the
electrical current that travels through the heart that causes the muscle of the
heart to contract. This effect can be used to correct abnormally rapid
heartbeats.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules:10 and 20 mg. Tablets: 30, 60, and 90 mg
STORAGE: Tablets should be stored at room temperature 15-25 C (59-77 F). They should be protected from light, moisture, and humidity.
PRESCRIBED FOR: Nifedipine is used for the treatment and prevention of angina
resulting from either an increased workload on the heart (as with exercise) or
spasm of the coronary arteries. It is used in the treatment of high blood
pressure, to treat abnormally fast heart rhythms such as atrial fibrillation,
and in the prevention of episodes of rapid heart rhythm originating from the
atria of the heart.
It also is used to dilate blood vessels that go into spasm
such as those causing Raynaud's phenomenon, a painful condition of the hands
caused by spasm of the arteries supplying blood to the hands. Non-FDA approved
uses include anal fissures (applied to the fissures), prevention of migraine
headaches in adults, ureteral stones (as secondary therapy) and wound healing
(applied to the skin).
DOSING: The usual dose for nifedipine capsules is 10 to 20 mg three times
daily. It is important to swallow capsules whole. For extended release tablets,
the usual dose is 30 or 60 mg once daily. The tablets should be swallowed whole
and not bitten or cut in half. Nifedipine can be taken with or without food.
DRUG INTERACTIONS: In rare instances, congestive heart failure has been
associated with nifedipine, usually in patients already on a beta blocker, for
example,
propranolol (Inderal), metoprolol (Lopressor), etc. Excessive lowering of blood
pressure (hypotension) during initiation of nifedipine treatment can occur,
especially in patients already taking another blood pressure lowering drug.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
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.
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.
An anal fissure is a small tear or cut in the skin lining of the anus. Pain and/or rectal bleeding during bowel movements are common symptoms of anal fissures. Treatment involves increasing liquid intake, using stool softeners and avoiding foods that may not be well-digested.
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.
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.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
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.
Achalasia is a disease of the esophagus that mainly affects young adults. Abnormal function of nerves and muscles of the esophagus causes difficulty swallowing and sometimes chest pain.
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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