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What Causes Dizziness And Swelling Of Feet While On BP Medication?
Question: Hello Dr. Rynne, my name is XXXXXXX XXXXX and I am writing from XXXXXXX My father, XXXXXX has had high blood pressure for many years but few months back it went around 165. The consulting doctor we have been visiting over here prescribed medications that brought down maintaining the BP at around 145 but my father is going through severe head reeling, dizziness and feet & ankle swelling, so much so he feels unable to do his every day regular chores comfortably and without fear. However the doctor says that these are the medications' side effects and we need to adjust to it as nothing can be done. Kindly help.
Brief Answer:
Require Large Drug Modifications in your case
Detailed Answer:
Hi Sir.
I understand your query and concern.
I have gone through all your uploaded reports in detail.
The Echo is showing LVH which is an indicative of uncontrolled long standing hypertension.
The Holter as well as Renal Doppler is within normal limits.
The LFT seems abnormal.This could be due to the drug Roseday 10 mg.
Your father seems to be on two antihypertensives like Cilacar and Asomex.
They both belong to same class called Calcium channel blockers.
The majority of symptoms you described are strongly related to the use of these two drugs.
Its highly recommended that these are substituted by Drugs called Telma and Metolar XL.
These two drugs are pretty safe and effective ,especially in presence of normal renal Doppler .
Also the use of TIDE 5 mg should be discouraged in the elderly since they produce serious electrolyte disturbances.
Roseday can be substituted for Aztor.
All these drug changes should be made only in consultation of your treating doctor.
Thank you.
Require Large Drug Modifications in your case
Detailed Answer:
Hi Sir.
I understand your query and concern.
I have gone through all your uploaded reports in detail.
The Echo is showing LVH which is an indicative of uncontrolled long standing hypertension.
The Holter as well as Renal Doppler is within normal limits.
The LFT seems abnormal.This could be due to the drug Roseday 10 mg.
Your father seems to be on two antihypertensives like Cilacar and Asomex.
They both belong to same class called Calcium channel blockers.
The majority of symptoms you described are strongly related to the use of these two drugs.
Its highly recommended that these are substituted by Drugs called Telma and Metolar XL.
These two drugs are pretty safe and effective ,especially in presence of normal renal Doppler .
Also the use of TIDE 5 mg should be discouraged in the elderly since they produce serious electrolyte disturbances.
Roseday can be substituted for Aztor.
All these drug changes should be made only in consultation of your treating doctor.
Thank you.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. Heijebu,
Thank You for your time and detailed explanation !!
However it piqued few more queries. Hopefully I am not troubling you.
Could you please explain what is LVH and LFT?
My father used to take Stamlo few years back but changed to Stamlo Beta because of unavailability or some reason I am not aware but afterwards changed to Telmark/Marktel as Beta did not work proper at all but he never faced these symptoms. As per him, there were some swelling when he was taking Marktel but negligible though BP kept fluctuating.... And only when his BP reached around 180 and then stayed at 165 {couple of nights he had trouble breathing and could not sleep] we consulted our doctor who asked for all these reports after which he prescribed the mentioned medications. These reports were done in the month of August 2014.
I have a doubt, they are saying the swelling could be side effect of the medications but more a result of kidney not functioning fully which is getting water stored in the legs. But if the Renal Doppler Study is showing everything is within normal limits then is it still the kidney?
Our Doctor had prescribed in the beginning:
1. Cilacar 10 [twice] 2. MarkTel [40+80-Twice-each once] 3. Moxilong 0.3 [Once] 4. Roseday 20 [Once]
When the BP did not reduce he changed MarkTel to Asomex 5 and Cilacar 10 to 20. This continued for few months but when my Father complained heavy head reeling he stopped Moxilong and started Tide 5 in its place to be taken in the morning. The head reeling did not get well at all and so last week when we visited the Doctor again, he changed Asomex to Arkamin 0.1 saying though it will reduce the swelling to some extent but will also have side effects of Nose/Mouth Dryness and Drowsiness and advised us to stop and return to Asomex immediately if it feels uncomfortable at all. But when it increased my Father's head reeling tremendously out of frustration he stopped Arkamin and did not continue with Asomex too for the next few days till now. He is saying he is feeling better but the reeling is there though reduced and swelling is there too. I am very much concerned as he is gradually getting a lot disheartened and losing hope as he is unable to do anything freely.
Kindly Please advise.
Is there any way that his BP could be brought under control with him feeling absolutely free of these side effects? He is doing regular mild exercises and eating healthy in small quantities but number of times. His Cholesterol is under control within limits when last checked couple of weeks back and his Sugar levels too are normal. He is 68 years old and his weight is 88 and height 5'-6". He is overweight but he has no unhealthy habits and a very calm person....never too hyper about anything.
As you have mentioned Telma and Metolar XL are safe and Renal Doppler is within normal , can they work fine for him and if yes, what should be their power and which medications should each substitute? Similar for Aztor too..what should be its power and should it be taken in the morning like Tide? And if they are safe, can I try substituting them now for few days to see the effects?
What are the symptoms of Electrolyte disturbances? Can they be dangerous? The last Echo was done almost six months back, should we go for another Echo? What is "uncontrolled long standing hypertension" and what are its symptoms and bad effects?
Kindly please advise.
Regards and Thanks,
Sincerely,
XXXXXXX XXXXXX
Thank You for your time and detailed explanation !!
However it piqued few more queries. Hopefully I am not troubling you.
Could you please explain what is LVH and LFT?
My father used to take Stamlo few years back but changed to Stamlo Beta because of unavailability or some reason I am not aware but afterwards changed to Telmark/Marktel as Beta did not work proper at all but he never faced these symptoms. As per him, there were some swelling when he was taking Marktel but negligible though BP kept fluctuating.... And only when his BP reached around 180 and then stayed at 165 {couple of nights he had trouble breathing and could not sleep] we consulted our doctor who asked for all these reports after which he prescribed the mentioned medications. These reports were done in the month of August 2014.
I have a doubt, they are saying the swelling could be side effect of the medications but more a result of kidney not functioning fully which is getting water stored in the legs. But if the Renal Doppler Study is showing everything is within normal limits then is it still the kidney?
Our Doctor had prescribed in the beginning:
1. Cilacar 10 [twice] 2. MarkTel [40+80-Twice-each once] 3. Moxilong 0.3 [Once] 4. Roseday 20 [Once]
When the BP did not reduce he changed MarkTel to Asomex 5 and Cilacar 10 to 20. This continued for few months but when my Father complained heavy head reeling he stopped Moxilong and started Tide 5 in its place to be taken in the morning. The head reeling did not get well at all and so last week when we visited the Doctor again, he changed Asomex to Arkamin 0.1 saying though it will reduce the swelling to some extent but will also have side effects of Nose/Mouth Dryness and Drowsiness and advised us to stop and return to Asomex immediately if it feels uncomfortable at all. But when it increased my Father's head reeling tremendously out of frustration he stopped Arkamin and did not continue with Asomex too for the next few days till now. He is saying he is feeling better but the reeling is there though reduced and swelling is there too. I am very much concerned as he is gradually getting a lot disheartened and losing hope as he is unable to do anything freely.
Kindly Please advise.
Is there any way that his BP could be brought under control with him feeling absolutely free of these side effects? He is doing regular mild exercises and eating healthy in small quantities but number of times. His Cholesterol is under control within limits when last checked couple of weeks back and his Sugar levels too are normal. He is 68 years old and his weight is 88 and height 5'-6". He is overweight but he has no unhealthy habits and a very calm person....never too hyper about anything.
As you have mentioned Telma and Metolar XL are safe and Renal Doppler is within normal , can they work fine for him and if yes, what should be their power and which medications should each substitute? Similar for Aztor too..what should be its power and should it be taken in the morning like Tide? And if they are safe, can I try substituting them now for few days to see the effects?
What are the symptoms of Electrolyte disturbances? Can they be dangerous? The last Echo was done almost six months back, should we go for another Echo? What is "uncontrolled long standing hypertension" and what are its symptoms and bad effects?
Kindly please advise.
Regards and Thanks,
Sincerely,
XXXXXXX XXXXXX
Brief Answer:
You do not need another ECHO now
Detailed Answer:
Hi Sir.
I understand your concern.
Your father has been prescribed many BP controlling pills earlier which had significant distress on his health.
The side effects are not related to kidney issues as told to you.They(leg swelling ) are related to the use of Cilacar and Asomex
The head reeling and Dizziness is largely related to the usage of Moxilong.
Its always advised to keep the random blood glucose under 130 mg% and fasting blood glucose under 110 mg %.
As far as blood pressure is concerned it should be kept under 125/80 mm of hg.
Telma can be taken as 40 mg per day in the afternoon post lunch.
Metolar XL can be started initially as 25 mg twice a day morning and night.Then based on the values of blood pressure obtained it can be titrated up to 50 mg.
LFT stands for liver function tests which is showing elevated enzyme values.
LVH indicates left ventricular hypertrophy which is increased mass of the left ventricular chamber of heart due to long standing hypertension.
This is documented on echo.LVH has to be controlled.
Uncontrolled Long standing hypertension implies elevated blood pressure for more than 6 months.This can have serious effects like heart attacks,brain strokes and kidney failure.
Telma can reverse LVH to a large extent.
Tide can cause electrolyte disturbances which is reflected as urinary loss of sodium and potassium.
Electrolyte disturbances can cause muscle weakness and brain damage.
Body electrolytes are tested through blood,not ECHO.
You do not need another echo
Blood pressure can be brought under control in your father's case with strict diet and drug regimes.
Restrict the intake of salt to less than 6 gm /day.
Intake of oatmeal for breakfast helps to control both BP and Cholesterol.
Aztor 20 mg can be given once daily at bedtime.This is followed by lipid profile testing initially every 6 months.
All the drug changes should be made only after consulting your treating physician.
Thank you
You do not need another ECHO now
Detailed Answer:
Hi Sir.
I understand your concern.
Your father has been prescribed many BP controlling pills earlier which had significant distress on his health.
The side effects are not related to kidney issues as told to you.They(leg swelling ) are related to the use of Cilacar and Asomex
The head reeling and Dizziness is largely related to the usage of Moxilong.
Its always advised to keep the random blood glucose under 130 mg% and fasting blood glucose under 110 mg %.
As far as blood pressure is concerned it should be kept under 125/80 mm of hg.
Telma can be taken as 40 mg per day in the afternoon post lunch.
Metolar XL can be started initially as 25 mg twice a day morning and night.Then based on the values of blood pressure obtained it can be titrated up to 50 mg.
LFT stands for liver function tests which is showing elevated enzyme values.
LVH indicates left ventricular hypertrophy which is increased mass of the left ventricular chamber of heart due to long standing hypertension.
This is documented on echo.LVH has to be controlled.
Uncontrolled Long standing hypertension implies elevated blood pressure for more than 6 months.This can have serious effects like heart attacks,brain strokes and kidney failure.
Telma can reverse LVH to a large extent.
Tide can cause electrolyte disturbances which is reflected as urinary loss of sodium and potassium.
Electrolyte disturbances can cause muscle weakness and brain damage.
Body electrolytes are tested through blood,not ECHO.
You do not need another echo
Blood pressure can be brought under control in your father's case with strict diet and drug regimes.
Restrict the intake of salt to less than 6 gm /day.
Intake of oatmeal for breakfast helps to control both BP and Cholesterol.
Aztor 20 mg can be given once daily at bedtime.This is followed by lipid profile testing initially every 6 months.
All the drug changes should be made only after consulting your treating physician.
Thank you
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank You again Doctor,
As I understand,
1. Telma 40 [Once-After Lunch]
2. Metolar XL 25 [Twice - Before Breakfast / Dinner]
3. Aztor 20 {Once-Bedtime]
Will it be okay to try these medications for a week or two and expect some positive changes ?
What should be the strict diet that would help?
What is the normal body Electrolyte conditions that should be checked while doing the test?
If Telman can reverse LVH to a large extent what can help LFT and how can we bring it to normal condition?
.and what BP values should I wait before titrating Metolar XL to 50 ?..and another important thing I need to understand, Doctor :
They were saying that some Aortic Valve has increased in mass which in result has decreased the diameter causing low blood flow to the heart which in turn is creating problem in its electrical function and is the main cause of the high BP values and it can be corrected only by removing that particular Valve by operation and then my father may need to be put on Pacemaker for the heart to function properly. Is this true and should I be worried regarding this in the near future?
Please Advise.
.and what are Calcium Channel Blockers....what do they work for ??
Sincerely,
XXXXXXX XXXXX
.....and what BP values should I wait before titrating Metolar XL to 50 ?
...and another important thing I need to understand, Doctor :
They were saying that some Aortic Valve has increased in mass which in result has decreased the diameter causing low blood flow to the heart which in turn is creating problem in its electrical function and is the main cause of the high BP values and it can be corrected only by removing that particular Valve by operation and then my father may need to be put on Pacemaker for the heart to function properly. Is this true and should I be worried regarding this in the near future?
Please Advise.
Sincerely,
XXXX
....and what are Calcium Channel Blockers....what do they work for ??
Sincerely,
XXXX
As I understand,
1. Telma 40 [Once-After Lunch]
2. Metolar XL 25 [Twice - Before Breakfast / Dinner]
3. Aztor 20 {Once-Bedtime]
Will it be okay to try these medications for a week or two and expect some positive changes ?
What should be the strict diet that would help?
What is the normal body Electrolyte conditions that should be checked while doing the test?
If Telman can reverse LVH to a large extent what can help LFT and how can we bring it to normal condition?
.and what BP values should I wait before titrating Metolar XL to 50 ?..and another important thing I need to understand, Doctor :
They were saying that some Aortic Valve has increased in mass which in result has decreased the diameter causing low blood flow to the heart which in turn is creating problem in its electrical function and is the main cause of the high BP values and it can be corrected only by removing that particular Valve by operation and then my father may need to be put on Pacemaker for the heart to function properly. Is this true and should I be worried regarding this in the near future?
Please Advise.
.and what are Calcium Channel Blockers....what do they work for ??
Sincerely,
XXXXXXX XXXXX
.....and what BP values should I wait before titrating Metolar XL to 50 ?
...and another important thing I need to understand, Doctor :
They were saying that some Aortic Valve has increased in mass which in result has decreased the diameter causing low blood flow to the heart which in turn is creating problem in its electrical function and is the main cause of the high BP values and it can be corrected only by removing that particular Valve by operation and then my father may need to be put on Pacemaker for the heart to function properly. Is this true and should I be worried regarding this in the near future?
Please Advise.
Sincerely,
XXXX
....and what are Calcium Channel Blockers....what do they work for ??
Sincerely,
XXXX
Brief Answer:
Vavular heart diseases can cause low blood flow to heart
Detailed Answer:
Hi Sir.
I understand your concern.
Yes you can have these medications for week or two to know the effects of these drugs,but only after consulting your treating physician.
The diet should include oat meal for breakfast .
Avoid fried and fatty stuff.
Cut down Coffee and tea to a large extent.Supplement with Health Drinks like Complan or Boost.
Fruits like Pomegranate contain Contain Plant Troponins,which are helpful in building the strength of heart muscle.One fruit a day at bed time is good.
The total calorie intake should not exceed 2100 kcal/day.For this you can have diet charts with listed calories available online to download.
One needs to wait for 2 weeks before titrating the dose of Metolar XL.
Only if the blood pressure is greater than 150 /80 mm of hg after the 2nd week,you need to increase the night dose to 50 mg.
This should be followed by another 2 week observation.If the average BP still continues to exceed 150 /80 mm of hg,you need to increase the morning dose to 50 mg as well.
Urine and Serum electrolytes can be tested once every 6 months.You need to check for Sodium,Potassium,Chloride and Bicarbonate.
LFT will normalise on its own slowly in 3-6 weeks with the aforesaid diet and drug changes.Repeat LFT after 6 months.
The need for aortic valve replacement and pacemaker implantation is not high in your case based on echo reports.
Yes certainly valvular diseases do cause impaired blood flow to heart.
But the elevated blood pressure can not alone be attributed to valvular changes alone at this age.Blood pressure can also be age related.
Even in cases of valvular replacement,you need not be concerned much,since the outcomes are good.
Calcium channel blockers are drugs which are mainly used for reducing the blood pressure.
Thank you.
Vavular heart diseases can cause low blood flow to heart
Detailed Answer:
Hi Sir.
I understand your concern.
Yes you can have these medications for week or two to know the effects of these drugs,but only after consulting your treating physician.
The diet should include oat meal for breakfast .
Avoid fried and fatty stuff.
Cut down Coffee and tea to a large extent.Supplement with Health Drinks like Complan or Boost.
Fruits like Pomegranate contain Contain Plant Troponins,which are helpful in building the strength of heart muscle.One fruit a day at bed time is good.
The total calorie intake should not exceed 2100 kcal/day.For this you can have diet charts with listed calories available online to download.
One needs to wait for 2 weeks before titrating the dose of Metolar XL.
Only if the blood pressure is greater than 150 /80 mm of hg after the 2nd week,you need to increase the night dose to 50 mg.
This should be followed by another 2 week observation.If the average BP still continues to exceed 150 /80 mm of hg,you need to increase the morning dose to 50 mg as well.
Urine and Serum electrolytes can be tested once every 6 months.You need to check for Sodium,Potassium,Chloride and Bicarbonate.
LFT will normalise on its own slowly in 3-6 weeks with the aforesaid diet and drug changes.Repeat LFT after 6 months.
The need for aortic valve replacement and pacemaker implantation is not high in your case based on echo reports.
Yes certainly valvular diseases do cause impaired blood flow to heart.
But the elevated blood pressure can not alone be attributed to valvular changes alone at this age.Blood pressure can also be age related.
Even in cases of valvular replacement,you need not be concerned much,since the outcomes are good.
Calcium channel blockers are drugs which are mainly used for reducing the blood pressure.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
Thank You for your patience Doctor.
Just one more question.
How low Diastolic Pressure should be alarming? Its mentioned everywhere that below 80 is good and normal but not how much below can be dangerous.....because lately my father's BP ranges at 145/59-62.
Just one more question.
How low Diastolic Pressure should be alarming? Its mentioned everywhere that below 80 is good and normal but not how much below can be dangerous.....because lately my father's BP ranges at 145/59-62.
Brief Answer:
Less Than 60 mm of Hg of Diastolic pressure is alarming.
Detailed Answer:
Hi Sir.
Diastolic blood pressure less than 60 mm of Hg should be a concern.60-80 mm of Hg is Relatively good.
Any blood pressure values less than 90/60 mm of Hg should immediately prompt urgent medical attention,because these pressures are associated with extremely low blood flow to vital body organs like brain and kidney.
Thank you.
Less Than 60 mm of Hg of Diastolic pressure is alarming.
Detailed Answer:
Hi Sir.
Diastolic blood pressure less than 60 mm of Hg should be a concern.60-80 mm of Hg is Relatively good.
Any blood pressure values less than 90/60 mm of Hg should immediately prompt urgent medical attention,because these pressures are associated with extremely low blood flow to vital body organs like brain and kidney.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
Doctor, what are the side effects we should see with these medications?? We started on them yesterday and in the evening his BP went up to 174/64.....stayed almost same in the night.... Today morning it is 164/62.....should we be concerned or wait??
Sincerely,
Sincerely,
Brief Answer:
Need not be concerned as of now.
Detailed Answer:
Hi Sir.
I understand your concern.
Its takes sometime for these drugs to have a full effect.
So you can wait for sometime like a week.So you need not be concerned at the moment.
These drugs are relatively free of side effects at ordinary therapeutic doses.
Basic side effects include diarrhoea,dry cough ,nausea etc.
Thank you
Need not be concerned as of now.
Detailed Answer:
Hi Sir.
I understand your concern.
Its takes sometime for these drugs to have a full effect.
So you can wait for sometime like a week.So you need not be concerned at the moment.
These drugs are relatively free of side effects at ordinary therapeutic doses.
Basic side effects include diarrhoea,dry cough ,nausea etc.
Thank you
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Doctor.....
I read in the Internet that slow respiration, confusion, memory difficulties, trouble in sleeping, weakness, skin rash, cold feeling in hands or feet, drowsiness, stomach inflammation, vomiting, flatulence, GI disorders, leg cramps and leg pains were some of the other side effects of both Telma and Metolar XL besides diarrhoea and dry cough that really got me very much worried....I sure don't hope and expect my Father to get into other problems to escape leg swelling and head reeling....but now that you said the effects will pass of in a week, I am slightly relaxed for now.
One more thing.....I was reading in another medical public forum that Telma H is better than Telma ......what is Telma H??
And Doctor, my Father was just telling today [I was not aware earlier] that he has been feeling some sort of ache and pain in his elbows, arms and legs since many days like an electric shock passing through or a joint pain.....at first we thought because he has had cold since day before yesterday it must be the general ache feeling but he confirmed its been there from before and since many days....
Is it anything alarming....or related to the medications he has been taking prior or is it because of his heart trouble or any alarm for any attack??
Should I go for the Electrolyte and Lipid profile check tomorrow or latest day after??
Sincerely,
Good Morning Doctor.....
We checked the BP in the morning...it was 144/66 and he seemed little fresh too unlike last week's tired and sick look. I believe the medications have started taking effect.....its a relief...I just hope it reduces more and makes him feel completely normal again...Thank You Doctor.
But there is one more thing.....he has had severe cold since this monday which has caused lots sputum and nose block too. He had been taking Cough Expectorant. Whether it is working or not it is not clear but yesterday night he could not sleep as it was difficult for him to breathe and he kept coughing.....we got worried for Chest Congestion. However, we did check his Sugar level too in the morning....it has elevated to 152. Is it because of the Expectorant?? He never had Sugar earlier but lately since few months it has developed.....but with diet control and exercise he had managed to reduce and bring it to 142 when checked last couple of weeks back..... He has not taken any medicine for Sugar yet. Please advise. What would suit for his cold, severe cough and high sugar with the current medication he is taking and as well the ache in his arms and legs???
Sincerely,
I read in the Internet that slow respiration, confusion, memory difficulties, trouble in sleeping, weakness, skin rash, cold feeling in hands or feet, drowsiness, stomach inflammation, vomiting, flatulence, GI disorders, leg cramps and leg pains were some of the other side effects of both Telma and Metolar XL besides diarrhoea and dry cough that really got me very much worried....I sure don't hope and expect my Father to get into other problems to escape leg swelling and head reeling....but now that you said the effects will pass of in a week, I am slightly relaxed for now.
One more thing.....I was reading in another medical public forum that Telma H is better than Telma ......what is Telma H??
And Doctor, my Father was just telling today [I was not aware earlier] that he has been feeling some sort of ache and pain in his elbows, arms and legs since many days like an electric shock passing through or a joint pain.....at first we thought because he has had cold since day before yesterday it must be the general ache feeling but he confirmed its been there from before and since many days....
Is it anything alarming....or related to the medications he has been taking prior or is it because of his heart trouble or any alarm for any attack??
Should I go for the Electrolyte and Lipid profile check tomorrow or latest day after??
Sincerely,
Good Morning Doctor.....
We checked the BP in the morning...it was 144/66 and he seemed little fresh too unlike last week's tired and sick look. I believe the medications have started taking effect.....its a relief...I just hope it reduces more and makes him feel completely normal again...Thank You Doctor.
But there is one more thing.....he has had severe cold since this monday which has caused lots sputum and nose block too. He had been taking Cough Expectorant. Whether it is working or not it is not clear but yesterday night he could not sleep as it was difficult for him to breathe and he kept coughing.....we got worried for Chest Congestion. However, we did check his Sugar level too in the morning....it has elevated to 152. Is it because of the Expectorant?? He never had Sugar earlier but lately since few months it has developed.....but with diet control and exercise he had managed to reduce and bring it to 142 when checked last couple of weeks back..... He has not taken any medicine for Sugar yet. Please advise. What would suit for his cold, severe cough and high sugar with the current medication he is taking and as well the ache in his arms and legs???
Sincerely,
Brief Answer:
Repeat tests after 24-48 hrs if symptoms do not subside.
Detailed Answer:
Hi Sir.
I understand your concern.
The list of side effects you mentioned from internet source are pretty uncommon in general population at the therapeutic doses.
Also, no drug is free of side effects. So do not focus much on them.
In Telma H, H stands for hydrochlorthiazide, which is similar to TIDE like drug you used earlier. Its nots safe in elderly as a maintenance anti hypertensive as it is known to cause electrolyte loss from the body on long term use.
Diffuse body aches can be a part viral cold illness, this need not paid much attention as the symptoms resolve spontaneously.
Any chest pain with radiation to arm has to be considered seriously with further cardiac work up in your father with echo evidence of Aortic stenosis and LVH.
You can go for baseline ECG, lipid profile and Serum electrolytes in case the symptoms does not resolve within 24 hrs.
The sleep disturbance and Sugar elevation are possibly related to the acquired cold rather to the expectorant.
Repeat Blood Glucose after 48 hrs.
Syrup Bro zedex would suit his status for cough and expectoration. It can be given thrice a day under medical prescription.
Thank you.
Repeat tests after 24-48 hrs if symptoms do not subside.
Detailed Answer:
Hi Sir.
I understand your concern.
The list of side effects you mentioned from internet source are pretty uncommon in general population at the therapeutic doses.
Also, no drug is free of side effects. So do not focus much on them.
In Telma H, H stands for hydrochlorthiazide, which is similar to TIDE like drug you used earlier. Its nots safe in elderly as a maintenance anti hypertensive as it is known to cause electrolyte loss from the body on long term use.
Diffuse body aches can be a part viral cold illness, this need not paid much attention as the symptoms resolve spontaneously.
Any chest pain with radiation to arm has to be considered seriously with further cardiac work up in your father with echo evidence of Aortic stenosis and LVH.
You can go for baseline ECG, lipid profile and Serum electrolytes in case the symptoms does not resolve within 24 hrs.
The sleep disturbance and Sugar elevation are possibly related to the acquired cold rather to the expectorant.
Repeat Blood Glucose after 48 hrs.
Syrup Bro zedex would suit his status for cough and expectoration. It can be given thrice a day under medical prescription.
Thank you.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
...he has not had any chest pain radiating to the arm yet....its just an ache in the arms elbows and legs...I will let you know if at all he goes through any such pain.... but thank you Doctor.
We will go for the blood sugar test again in 48 hrs....and wait a week for the Lipid profile test.
Doctor how long do we need to continue with this medication...you had mentioned earlier that with the current medications the LFT and LVH can get better and normalize.....is there any hope that may be the medications can stop if he follows the strict diet and drug regime ??
I will get the Syrup Bro Zedex tomorrow and try.
Sincerely,
We will go for the blood sugar test again in 48 hrs....and wait a week for the Lipid profile test.
Doctor how long do we need to continue with this medication...you had mentioned earlier that with the current medications the LFT and LVH can get better and normalize.....is there any hope that may be the medications can stop if he follows the strict diet and drug regime ??
I will get the Syrup Bro Zedex tomorrow and try.
Sincerely,
Brief Answer:
Anti hypertensives should be continued lifelong in most cases.
Detailed Answer:
Hi Sir.
I understand your concern.
It takes approximately 6-8 months for 90 % reversal of LVH by Telma.
Some individuals may take more time than this.
In-spite of good drug and dietary regimen ,there is never an evidence to discontinue the drugs on normalisation of blood pressure.
Discontinuation of Anti hypertensives in individuals with age related essential hypertension can cause rebound elevation of blood pressure which is often difficult to control.
Hence these drugs should not be discontinued at any cost in your case.
Thank you
Anti hypertensives should be continued lifelong in most cases.
Detailed Answer:
Hi Sir.
I understand your concern.
It takes approximately 6-8 months for 90 % reversal of LVH by Telma.
Some individuals may take more time than this.
In-spite of good drug and dietary regimen ,there is never an evidence to discontinue the drugs on normalisation of blood pressure.
Discontinuation of Anti hypertensives in individuals with age related essential hypertension can cause rebound elevation of blood pressure which is often difficult to control.
Hence these drugs should not be discontinued at any cost in your case.
Thank you
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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