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.
ACE is important because it is an enzyme responsible for
producing the chemical, angiotensin II. Angiotensin II causes muscles in most
arteries, including the arteries of the heart, to contract, thereby narrowing
the arteries and elevating blood pressure. ACE inhibitors such as ramipril
lower blood pressure by reducing the production of angiotensin II, thereby
relaxing arterial muscle and enlarging arteries. When the blood pressure is
lower, the heart - including the failing heart - does not have to work as hard to
pump blood. The arteries supplying the heart with blood also enlarge during
treatment with ACE inhibitors. This increases the flow of blood and oxygen to
the heart, further improving the ability of the heart to pump blood.
The effects
of ACE inhibitors are particularly beneficial to people with congestive heart
failure. In the kidneys, the narrowing of the arteries by angiotensin II
decreases blood flow. ACE inhibitors enlarge and reduce the blood pressure in
the arteries going to the kidney. This reduces damage to the kidneys caused by
high blood pressure. The FDA approved ramipril in 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules or tablets: 1.25, 2.5, 5 and 10 mg
STORAGE: Tablets and capsules should be stored at room temperature
between 15-30 C (59-86 F).
PRESCRIBED FOR: Ramipril is used for the treatment of congestive heart
failure (CHF) and hypertension (high blood pressure). Ramipril also prevents
heart attacks, strokes and deaths due to heart disease in patients who have risk
factors for such events. After a heart attack, ramipril reduces progression to
severe or resistant heart failure, hospitalization related to heart failure, and
heart disease-related death. Like other ACE inhibitors, ramipril may slow the
progression of kidney failure in patients with hypertension or diabetes by
reducing the damage to the kidneys caused by high blood pressure.
DOSING: The usual dose of ramipril is 2.5-20 mg a day as a single dose
or two divided doses. Patients taking diuretics or who have renal artery
stenosis (narrowing of the arteries going to the kidney) may require lower
doses.
DRUG INTERACTIONS: The use of ACE inhibitors with potassium
supplements, salt substitutes or diuretics [for example, spironolactone
(Aldactone) that
increase potassium in the blood may lead to excessive potassium levels.
Potassium levels should be monitored whenever ACE inhibitors are used in
combination with these drugs.
There have been reports of increased lithium
(Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The
reason for this interaction is not known.
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.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
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 disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
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.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
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.
Coronary artery disease is the most common cause of death in the United
States. Over a million people each year will have a heart attack and 25% will
die before they get to the hospital while or in the Emergency Department.
Prevention is the key to treatment of heart disease.
Diagnosis of heart disease is often made by careful history taken by a health care
practitioner.
Some individuals may have atypical symptoms, including almost none at all.
The testing strategy to confirm the diagnosis and plan appropriate
treatment needs to be individualized for each patient diagnosed with heart
disease.
Treatment of heart disease depends upon the severity of disease, and is often directed by the
symptoms experienced by the affected individual.
Introduction to heart disease
The heart is like any other muscle, requiring oxygen and nutrient-rich blood for it t...
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