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Suggest Treatment For Sleeplessness, Increased Blood Pressure And Sudden Increase In Pulse Rate

Posted on Fri, 14 Jul 2023

Question: Hello Doc,

As asked by you on the below 2 questions
1. Is she having known allergies? - No she is not having known allergies
2. Is she having running nose or sneezing or throat irritation? No running nose or sneezing at times some throat irritation

Please advice which tablets she should take and for what duration

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Telekast is having montelukast plain.
Mondeslor is having combination of montelukast and desloratidine (antihistamine).
Doxolin is oral bronchodilator.
So all three of them are different.
Please let me know
1. Is she having known allergies?
2. Is she having running nose or sneezing or throat irritation?
Please reply me answers of above asked questions so that I can guide you which drug should be started in her case.
Honestly speaking, seroflo is best for asthma. But salmeterol will cause palpitations in her.
So if she can tolerate palpitations then seroflo is better than budecort.
I will be happy to help you further. Wishing good health to your mother. Thanks.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Just give her plain Montelukast.

Detailed Answer:

Hello,

Since she is not having allergies and no nasal symptoms, no need to give Mondeslor.

Give her plain Montelukast (Telekast) once daily at night time before going to sleep for 2-3 months.

Doxophylline is oral bronchodilator. It can also cause tachycardia and palpitations. So better to stop Doxophylline.

Try to start ultra long-acting inhaled bronchodilators (Indacaterol and Glycopyronium). These are prescription based medications.

It won't cause tachycardia.

Please let me know:
1. Where is she living? In India?
2. Has she ever tried ultra long-acting inhaled bronchodilators?
Please let me know answers to above-asked questions so that I can guide you better. I will be happy to help you further.

Wishing good health to your mother.

Thanks.

Regards,
Dr. Kaushal Bhavsar, Pulmonologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Drkaushal85 (13 hours later)

Hi Doc,

we did the sleep study at home yesterday and I am attaching the reports ,please advice further

Regards,

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
What is the indication for sleep study?

Detailed Answer:

Hello,

Sorry to say but I have to ask this because you have put sleep study report in front of me all of a sudden.

May I know
1. What was the indication of sleep study?
2. What are her symptoms regarding sleep apnea?
3. Is she obese P?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.

Wishing good health to your mother. Thanks.

Regards,
Dr. Kaushal Bhavsar, Pulmonologist

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (54 minutes later)

Hello doc

From past 7 to 8 months she was not getting proper sleep her blood pressure increased suddenly pulse rate increased to 100 and above most of the time . And her breathing use to stop for seconds in the night. She feela tired the whole day and sleeps in the mid morning and afternoon. Her wheezing and snoring got very high and hence we got this test done.
Her weight is 69 and height is 5ft 2 inches.

Can you please evalaute the report and help me underatand what should be the bext step

Answered by Dr. Drkaushal85 (17 hours later)

Brief Answer:
She should undergo titration study with BiPAP.

Detailed Answer:

Hello,

According to this sleep study report, she needs titration study with BiPAP.

In this another sleep study is done with BiPAP machine on.
In this we are looking for improvement in sleep report values, improvement in symptoms with BiPAP.
So discuss with her sleep doctor about titration study.

Hope I have solved your query. I will be happy to help you further.

Wishing good health to your mother. Thanks.

Regards,
Dr. Kaushal Bhavsar, Pulmonologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (2 hours later)

Hi Doc,

We were advised to do the APAP titration . But my mom felt super uncomfortable with the full mask and even with just the nasal mask even for 30 min.

But somehow she managed to do for 4 hours with the nasal mask only but she was awake the whole night and was not able to sleep. Report is awaited and I will share with you.

Regards,
XXXX

Hi Doc,
attached report, please help evaluate and guide further . My mom says she was not able to sleep with the APAP machine but somehow she managed for 4 hours

Regards,
XXXX

Answered by Dr. Drkaushal85 (22 hours later)

Brief Answer:
This report is not sufficient.

Detailed Answer:

Hello,

This report is not satisfactory because of shorter duration.
Now we have to decide upon patient's symptoms after BiPAP use.
So please let me know
1. Was she comfortable after BiPAP use?
2. Was she feeling good after BiPAP use?
3. Was her next day refreshing after BiPAP use?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further.

Wishing good health to your mother. Thanks.

Regards,
Dr. Kaushal Bhavsar, Pulmonologist

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Above answer was peer-reviewed by : Dr. Vaishalee Punj