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Suggest Treatment For Coronary Artery Disease And CKD In A CABG Patient

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Posted on Tue, 1 Apr 2014
Twitter Tue, 1 Apr 2014 Answered on
Twitter Thu, 4 Jan 2024 Last reviewed on
Question : Dear Doc - My mother is a CABG patient , CKD , Diabetic Nephropathic , 70 years of age . Recently she was hospitalized (for Hypokalemia and HyperCalcemia ) and a new medicine was introduced for her PROLOMET XL 50 (ONCE A DAY) , my question is it is safe for my mother to continue this medicine lifelong ? Since a long time now , she was on LOSAR 25 , CLODREL PLUS , LIPICARD 160 , TONACT 10 . Her diabetologist discontinued losar 25 since last 6 months . Please help me understand if PROLOMET XL 50 (which i understand is a Beta Blocker and hypertension medicine) is safe considering her medical condtions.
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Answered by Dr. Sukhvinder Singh (33 minutes later)
Brief Answer: please see details Detailed Answer: Dear Sir Whenever a medication is prescribed, the pros and cons for same are evaluated thoroughly. If there is any absolute contraindication (prohibition) we do not prescribe that medicine. However in rest of cases, benefits are weighed against possible risks. Since the patient is Post CABG, a beta-blocker is very much indicated. All patients with coronary artery disease including post CABG patient should receive beta-blockers in the absence of contraindications. Chronic kidney disease is not a contraindication. diabetes itself is not a contraindication, however , some people have concern that if patient develops low glucose, the signs of low glucose may not be apparent. This is more of a theoretical consideration for PROLOMET or metoprolol (beta 1 selective agent) and benefits outweigh risk as per standard literature. Otherwise also, beta-blockers may worsen diabetic control but harm is not sufficient enough to preclude their use for a post CABG patient. Other major contraindications are conduction disorder of heart, bronchial asthma, peripheral vascular disease or class IV heart failure which I hope your doctor must have ruled out. Hope this provides some insight. Feel free to discuss further. Sincerely Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sukhvinder Singh

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Suggest Treatment For Coronary Artery Disease And CKD In A CABG Patient

Brief Answer: please see details Detailed Answer: Dear Sir Whenever a medication is prescribed, the pros and cons for same are evaluated thoroughly. If there is any absolute contraindication (prohibition) we do not prescribe that medicine. However in rest of cases, benefits are weighed against possible risks. Since the patient is Post CABG, a beta-blocker is very much indicated. All patients with coronary artery disease including post CABG patient should receive beta-blockers in the absence of contraindications. Chronic kidney disease is not a contraindication. diabetes itself is not a contraindication, however , some people have concern that if patient develops low glucose, the signs of low glucose may not be apparent. This is more of a theoretical consideration for PROLOMET or metoprolol (beta 1 selective agent) and benefits outweigh risk as per standard literature. Otherwise also, beta-blockers may worsen diabetic control but harm is not sufficient enough to preclude their use for a post CABG patient. Other major contraindications are conduction disorder of heart, bronchial asthma, peripheral vascular disease or class IV heart failure which I hope your doctor must have ruled out. Hope this provides some insight. Feel free to discuss further. Sincerely Sukhvinder