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.
Nifedipine decreases the
elimination of digoxin (Lanoxin) by the kidneys which can increase digoxin blood
levels in the blood and give rise to digoxin toxicity. It is important,
therefore, to monitor blood levels of digoxin in order to avoid toxicity.
Nifedipine interferes with the breakdown of tacrolimus (Prograf) by the liver,
which in turn causes elevated blood levels of tacrolimus and may increase the
risk of toxicity from tacrolimus.
Nifedipine reduces the blood levels of
quinidine (Quinaglute, Quinidex, Quinora) which may reduce the effectiveness of
quinidine. Conversely, blood levels of nifedipine are increased by quinidine and
may lead to side effects from nifedipine.
Cimetidine (Tagamet) interferes with
breakdown by the liver of nifedipine and increases nifedipine blood levels.
Therefore, cautious dosing is necessary when both medications are administered
concurrently.
Nifedipine should not be taken with grapefruit juice since
grapefruit juice (one glass, approximately 200 ml) inhibits the breakdown of
nifedipine by the liver and increases the levels of nifedipine in the blood.
PREGNANCY: There are no adequate studies of nifedipine in pregnant women, and in
general, it is avoided during pregnancy.
NURSING MOTHERS: Nifedipine is excreted in human
breast milk. Generally,
nifedipine is avoided in nursing mothers.
SIDE EFFECTS: Side effects of nifedipine are generally mild, and reversible.
Most side effects are expected consequences of the dilation of the arteries. The
most common side effects include headache, dizziness, flushing, and edema
(swelling) of the lower extremities. Less common side effects include dizziness,
nausea and constipation.
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.
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