"Dr. Andrew B. Chung, MD/PhD" <
[email protected]> wrote in message
news:[email protected]...
> "bnd777" <
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news:<
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> > "Dr. Andrew B. Chung, MD/PhD" <
[email protected]> wrote in message
> >
news:[email protected]...
> > > "bnd777" <
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> > news:<
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> > > > 87 yr old female as previously posted
> > > >
> > > > Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been
> > > > on it for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not
> > > > touch )
> > >
> > > Though I am not familiar with Arcoxia specifically, as a class, NSAIDs do make hypertension
> > > more difficult to control. Would suggest you ask about narcotics or "alternative" methods of
> > > pain control (acupuncture?)
> > >
> > > > Has been taking Atenolol 50mg
> > >
> > > Atenolol is not a good beta blocker for the elderly who tend to have decreased renal function
> > > (it is renally cleared). Would suggest you ask about a change to a non-renally metabolized beta-
> > > blocker.
> > >
> > > > Tritace 10mg
> > >
> > > Given you describe what is likely an ACE inhibitor cough, this may not be a good choice either
> > > especially if the cough is causing sleep deprivation, which can also make hypertension more
> > > labile (difficult to control). Would suggest you ask about ARBs (angiotensin receptor
> > > blockers) as an alternative.
> > >
> > > > Bendrofluazide 2.5mg
> > >
> > > Thiazide diuretics are less effective in the elderly especially if there is decreased renal
> > > function. Would suggest you ask about a change to loop diuretics.
> > >
> > > > and Plendil 2.5 mg was added 2 weeks ago
> > >
> > > Calcium channel blockers can worsen edema. They may not even be necessary if the rest of her
> > > medications were more "optimal."
> > >
> > > > Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has
> > > > cataracts ) noisy breathing/breathless
> > > >
> > > > Comments welcome
> > >
> > > Hope my comments help.
> > >
> > > Humbly,
> > >
> > > Andrew
> > >
> > > --
> > > Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist
http://www.heartmdphd.com
> >
> >
> > They sure explain a lot but to get them changed to what you suggest
would
> > mean sending her doctors back to med school !!!!!!!!!!!!!
>
> That shouldn't be necessary. Having them read this should help them
rethink things.
>
> Humbly,
>
> Andrew
>
> --
> Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist
http://www.heartmdphd.com
In the UK if you dare go to your doctors with anything printed off the internet they show you the
door !!!!!!!!!!!!
Doctors and Specialists in the UK often never ever update their knowledge from the day they left
medical school
BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs but it certainly does have the
side effect listed of rare cause of Hypertension As no other NSAIDs touch the pain and difficulty
she suffers due to collapsed spine from osteoporosis and it took 9 months of waiting to even see the
specialist who prescribed Arcoxia there will be little point trying to get any meds changes
I am very grateful for your help and astounded by your depth of knowledge ......seems our doctors
need to go back to med school fast