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.
Phenothiazines such as thioridazine (Mellaril), an antipsychotic drug, and
tricyclic antidepressants such as amitriptyline (Elavil,
Endep) should not be used with
quinidine since they can cause cardiac arrhythmias, and their use with quinidine
increases the risk of cardiac arrhythmias.
Quinidine increases the action of the blood thinner warfarin (Coumadin), due
to synergistic effects and can lead to excessive blood thinning and bleeding. A
decrease in warfarin dose usually is required. Blood levels of digoxin
(Lanoxin) are
raised by quinidine due to a reduction in removal or reduced distribution in the
body of digoxin. This can give rise to intoxication with digoxin, and it is
important to reduce the dose of digoxin to prevent toxicity.
Removal of quinidine by the liver is accelerated by phenobarbital,
phenytoin
(Dilantin), and rifampin (Rifamate), requiring an increase in quinidine dose.
With the exact mechanism not known, amiodarone (Cordarone), another type of
antiarrhythmic drug, may decrease removal of quinidine by the kidneys or liver
giving rise to elevated quinidine blood levels, which may result in
life-threatening arrhythmias, including torsades de pointes. It is important,
therefore, to decrease quinidine doses when it is given concomitantly with
amiodarone.
Cimetidine (Tagamet) increases quinidine levels by decreasing the elimination
of quinidine giving rise to elevated quinidine serum levels that may lead to
quinidine toxicity.
PREGNANCY: Safety and efficacy of quinidine has not been established in
pregnant women.
NURSING MOTHERS: Quinidine can enter
breast milk and should be avoided by
nursing mothers.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Palpitations are unpleasant sensations of irregular and/or forceful beating of the heart. Palpitations can be relieved in many patients by stress reduction, stopping cigarettes, and reduction of caffeine and alcohol.
Malaria is an infectious disease transmitted by the bite of an infected Anopheles mosquito. Symptoms of malaria include chills, pain, fever, and sweating. Though mild cases of malaria can be treated with oral medication, severe cases require intravenous drug treatment and fluids.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
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.
Paroxysmal supraventricular tachycardia (PSVT) is an abnormal conduction of electricity in particular areas of the heart. PSVT was referred to at one time as paroxysmal atrial tachycardia or PAT, however, the term PAT is reserved for as specific heart condition. Symptoms of PSVT include weakness, shortness of breath, chest pressure, lightheadedness, and palpitations. PSVT is treated with medications or procedures that return the heart to its normal electrical pattern.
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