I. Verapamil Fact File
Verapamil was introduced by Genpharm Inc.
From its modest beginnings in 1983 as an R&D facility, Genpharm has grown to be one of Canada's top 20 pharmaceutical companies. Today, Genpharm Inc. is a leading manufacturer of generic pharmaceuticals, with prescription products encompassing all major therapeutic classes. Genpharm's Hospital Division supplies an expanding range of equipment and pharmaceuticals for renal dialysis and is quickly becoming recognized as a leader in this field.
Genpharm Inc. is one of many affiliated companies, which comprise the worldwide group of Merck Generics, a subsidiary of Merck KGaA, the oldest pharmaceutical company in the world.
II. Verapamil Medication
Besides Verapamil, Verapamil is available with the following Brand names: Verapamil SR, Isoptin SR, Verelan, Verelan PM.
Verapamil is used to treat irregular heartbeats (arrhythmias) and high blood pressure. It relaxes your blood vessels so your heart does not have to pump as hard.
Verapamil also increases the supply of blood and oxygen to the heart to control chest pain (angina). If taken regularly, Verapamil controls chest pain, but it does not stop chest pain once it starts. Your doctor may give you a different medication to take when you have chest pain.
Antihypertensives: Information
Antihypertensives include:
- Diuretics ("water pills")
- Beta Blockers
- Alpha Blockers
- Alpha-Beta Blockers
- Sympathetic Nerve Inhibitors
- Angiotensin Converting Enzyme (ACE) Inhibitors
- Calcium Channel Blockers
- Angiotensin Receptor Blockers (formal medical name angiotensin-2-receptor antagonists, known as "sartans" for short). These agents are sometimes prescribed together, for instance an ACE inhibitor along with a calcium channel blocker.
In general, antihypertensives work through one or more of the following mechanisms:
- By Decreasing Blood Volume
- By Opening Up Blood Vessels, either by
- Inhibiting Constriction (narrowing) or
- Stimulating Dilation (widening), to make it easier for blood to flow through the arteries
- By Decreasing Rate and/or Force of Contraction of the Heart, thus decreasing the amount of blood pumped through the arteries
Calcium channel blockers prevent calcium from flowing into heart muscle cells and muscle cells of the blood vessel walls, resulting in slowing of heart rate and relaxation of blood vessels.
Common calcium channel blockers include:
- Amlodipine (brand name Norvasc)
- Diltiazem (Cardizem)
- Felodipine (Plendil)
- Isradipine (DynaCirc)
- Nicardipine (Cardene)
- Nifedipine (Procardia)
- Verapamil (Verapamil, Covera-HSâ, Verelan)
Hypertension (High Blood Pressure): Information
Approximately 50 million Americans aged 6 and older have elevated blood pressure (hypertension). In approximately 15% of these patients, a specific cause (i.e., Cushing's disease) can be identified: the remainder are said to have primary (essential) hypertension.
Diagram: Blood Pressure
Diagram: Hypertension
High blood pressure, sometimes called hypertension, means high pressure (tension) in the arteries. It does not mean excess emotional stress, though doctors' believe that stress might contribute to high blood pressure over a longer period of time.
Your blood pressure rises and falls with each heartbeat, even normal blood pressure does this. These levels can change with everyday activity, for example, during exercise or when you are asleep and this is also normal.
However, in some people, and as we get older, these changes in blood pressure start to happen at higher pressure levels than normal and this is what high blood pressure means.
Your blood pressure is usually measured with a blood pressure cuff placed around the upper arm that registers the pressure in units called millimeters of mercury (or mm Hg).
Your blood pressure is usually considered to be high when it is at a level exceeding 140/90 mm Hg (“140 over 90”) on several readings under various conditions. However, defining normal and abnormal is not always so clear-cut and your doctor or healthcare professional will make the necessary recommendations.
Blood pressure rises and falls with each heartbeat. Systolic blood pressure, the higher number, represents the pressure in the arteries as the heart contracts and sends blood into the circulation.
Diastolic pressure, the lower number, occurs as the heart relaxes following a beat. It represents the lowest pressure to which the arteries are exposed between heartbeats.
High blood pressure may be present for several years before it is detected and is often found during a routine check-up, for example, for insurance purposes. Usually there are no symptoms and consequences may only become apparent after many years.
Doctors know that there is a benefit from treating high blood pressure at any age, even in older patients of 65 years and over. Depending on the level of the blood pressure, different things are recommended. In some people with only mild elevations in blood pressure a change in diet and adopting a more healthy lifestyle may reduce the blood pressure to normal. Your healthcare professional will provide you with the right diet for you. Its not just lowering the amount of salt you eat, although this is important: there are other things you can change in your diet that can help.
 Also, if you are overweight, getting slimmer may help.
If necessary, high blood pressure can be treated with a range of different medicines, including:
- Beta-blockers, which make the heart beat more slowly and less strongly. They work by blocking the action of nerves supplying the heart that release a chemical called noradrenaline. This helps to control the rhythm and force of heart muscle movement. They also block a hormone called adrenaline (a chemical carried in the blood), which is similar to noradrenaline.
- Diuretics, which work in the kidneys to make you pass urine more often and get rid of excess fluid.
- Calcium-channel blockers, which relax arterial blood vessels making them less narrow. These lower the resistance to blood flow, allowing blood to flow more easily. They work by preventing calcium from entering the muscles in blood vessels because calcium is important in narrowing down blood vessels.
- ACE inhibitors and angiotensin II antagonists, which in general relax the blood vessels. They do this by preventing a hormone called angiotensin II from working, either by preventing its production or blocking its action. Like other hormones, angiotensin II is an active chemical signal in the blood. It controls the function of many organs or systems including the narrowing of blood vessels and prevents the kidneys from getting rid of excess fluid. Doctors believe that angiotensin II is involved as one of the causes of high blood pressure.
It is also important to follow any lifestyle instructions that your doctor has given to you, like trying to give up smoking, reducing your weight, doing more exercise and eating a healthy diet. When these and other risk factors are present together with high blood pressure, then this means there is even higher risk of serious disease.
It is also important to continue taking any medications you have been given, even if you feel normal.
No specific cause is found in 95% of patients with hypertension – this is called primary hypertension or sometimes, essential hypertension.
Most patients have primary, or essential hypertension. Most cases of primary hypertension are due to increased stiffness and narrowing of the smaller (peripheral) arteries.
This results in increased resistance to the flow of blood and is what makes the blood pressure go up.
Increased peripheral artery resistance is associated with genetics (family history), obesity, lack of exercise, over use of salt, and the natural ageing process.
A few patients have high blood pressure with a known cause (secondary hypertension). Long-lasting (chronic) kidney disease accounts for most of these patients where there is excessive fluid accumulation in the body that raises blood pressure. Hypertension can also occur during some pregnancies.
Side Effects of Antihypertensives
Note: Decreased blood pressure in a mother also has the potential to harm her developing baby. Since blood volume determines the amount of blood filtered/urine processed by the kidneys, antihypertensives have effects on that organ as well. Although in general blood-pressure-lowering medicines reduce strain on the kidney, some antihypertensives like sartans can nevertheless worsen kidney disease.
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III. Useful links
Government http://www.cdc.gov/
http://www.fda.gov/
http://www.fda.gov/cder/ogd/
http://www.nih.gov/
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
http://www.health.gov.on.ca/
National Library of Medicine
World Health Organization
Health Sites
http://www.mayoclinic.com/index.cfm
MedicineNet.com
Drugdigest.org
Healthsquare.com
About.com Health section
http://www.genpharm.ca/index2.asp
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a684030.html
http://tjsamson.client.web-health.com/web-health/topics/GeneralHealth/generalhealthsub/generalhealth/cardiovascular/antihypertensives.html
http://lysine.pharm.utah.edu/netpharm/netpharm_00/notes/antihypertensives.html#Introduction
http://www.patienthealthinternational.com/article/501305.aspx
Pharmacy sites
http://www.roche.com/home/company/com_hist.htm
http://www.healthdigest.org/Bactrim-DS(Oral)_2006_PRO.php
http://www.hsforum.com/stories/storyReader$1509
http://www.hsforum.com/stories/storyReader$1516
http://www.hsforum.com/stories/storyReader$1504
http://www.americanheart.org/presenter.jhtml?identifier=4443
http://www.people.vcu.edu/~urdesai/atc.htm#Process%20of%20clotting
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