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: Quinapril belongs in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are used for treating high blood pressure and heart failure and for preventing kidney failure due to hypertension and diabetes. Other drugs in this class are enalapril (Vasotec), ramipril (Altace), captopril (Capoten), fosinopril (Monopril), benazepril (Lotensin), lisinopril (Zestril, Prinivil), moexipril (Univasc) and trandolapril (Mavik). Angiotensin converting enzyme is important because it produces angiotensin II. Angiotensin II contracts the muscles of the arteries in the heart and the rest of the body, narrowing the arteries and thereby elevating blood pressure. In the kidney, the narrowing caused by angiotensin II decreases blood flow and increases the filtration pressure in the kidney. ACE inhibitors such as quinapril lower blood pressure by inhibiting the formation of angiotensin II, thereby relaxing the arterial muscles and enlarging the arteries. This increases the flow of blood and oxygen to the heart so that it can pump blood more efficiently. The enlargement of the arteries elsewhere in the body also makes it easier for the heart to pump blood. This is particularly beneficial when there is heart failure. In the kidneys this increases blood flow and reduces the filtration pressure in the kidneys. Quinapril was approved by the FDA in November, 1991.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Tablets: 5, 10, 20 and 40 mg
STORAGE:Store tablets and solutions at room temperature 15-30°C (59-86°F).
PRESCRIBED FOR: Quinapril is used alone or in combination with other drugs to treat hypertension and heart failure. As with other ACE inhibitors, quinapril also is used to delay the progression of kidney failure in patients with diabetes.
DOSING: The recommended dose for treating hypertension is 10-80 mg a day as a single dose or in two doses. The dose for heart failure is 20-40 mg a day in two divided doses. Quinapril should be taken on an empty stomach because food reduces its absorption.
DRUG INTERACTIONS: The use of ACE inhibitors with potassium supplements, salt substitutes or diuretics (e.g., spironolactone) that increase potassium in the blood may lead to excessive potassium levels. Potassium levels should be closely monitored whenever ace inhibitors are use in combination with these drugs.
There have been reports of increased lithium (Eskalith) levels when lithium is used in combination with ace inhibitors. The reason for this interaction is not known.
Nitritoid reactions (symptoms
includie facial flushing, nausea, vomiting and hypotension) may occur when
injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid
arthritis, is combined with ACE inhibitors, including quinapril.
PREGNANCY: Angiotensin converting enzyme inhibitors, including quinapril, are very harmful to the fetus and, therefore, should not be used during pregnancy.
NURSING MOTHERS: Quinapril is secreted into breast milk. Because of the risk of harm to the infant, quinapril should be used with caution during breast feeding.
SIDE EFFECTS: Quinapril is generally well tolerated, and side effects are usually mild and transient. A dry, persistent cough has been reported with the use of quinapril and other ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects include abdominal pain, constipation, diarrhea, rash, dizziness, fatigue, headache, loss of taste, loss of appetite, nausea, vomiting, fainting and numbness or tingling in the hands or feet. Quinapril and other ACE inhibitors may also cause kidney failure and increased levels of potassium in the blood. The most serious but very rare side effects are liver failure and angioedema (swelling of lips and throat).
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.
High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.
The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.
An elevation of the systolic and/or diastolic blood pressure increas...
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