Brief Answer:
no picture uploaded

Detailed Answer:
Hello,

please try to upload the pictures again, because no picture is accessible.
Also please clarify your questions a little bit. Do you need to know the right dosages or how important they are. A medical history would help a lot, please include all the details you can.

I'll be glad to answer, when you provide the necessary details.

Kind Regards!

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Brief Answer:
Please review the recommended doses

Detailed Answer:
Hi,

although you haven't provided the clarifications that I've asked for, I suppose you need the daily dosage of the handwritten prescription drugs.
Let me start from the easy part.

Omeprazole should be used once per day unless it's given for the treatment of peptic ulcer or esophagitis. Many cardiologists prescribe omeprazole as a preventive measure, so once per day should be enough.

The rest of the drugs, may be given once or multiple times (particularly the diuretics) depending on the patient. You should contact your doctor for that. I'll give you something to consider till you do though.

Aldactone (spironolactone) 25mg was given once in the morning and once in the afternoon in the old prescription, so I guess dosage would be a reasonable choice unless the patient had hyperkalemia or very low blood pressure.

Lasix (furosemide) was not given before but a similar drug (torsemide-Dytol) was. Keeping the same dosage sounds reasonable too. Once in the morning and once in the afternoon. Lasix may cause hypokalemia and hypotension, so you should consider that too. Lasix will make swollen legs and congested lungs loose the excess water and improve their appearance and function.

Finally diovan (valsartan) is usually given in low doses in heart failure (which I suppose is the diagnosis). 80mg per day, once in the morning could be enough, although you should use the blood pressure as a guidance.

You should definitely try to get more detailed instructions from the treating physician. Until you do, checking the blood pressure, the respiratory status and the electrolytes (sodium, potassium) would be very helpful in deciding how to modify dosages.

I hope I've helped!
Contact me again using your follow-up questions, if you still need to ask something.

Kind Regards!

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Brief Answer:
lasix is a very good drug

Detailed Answer:
Hi,

lasix is a very good drug - and almost irreplacable - for heart failure. Do not fear the low potassium because although it's a serious complication - it can be managed by modifying lasix and aldactone dosage. That's why I've asked you about electrolyte disorders.
For example, if you have recent tests and your mother had a very low potassium level (which I suspect due to the potassium supplementation in the old prescription) then lasix should be used cautiously. Aldactone on the other hand causes the potassium levels to rise, so a balance between them can be found.

As I wrote in my previous answer lasix once or twice per day is a reasonable choice unless your mother seems to be accumulating fluid in her body (leg swelling, shortness of breath). The handwritten prescription is not very clear. There might be a "od" after lasix which means once per day but it's not clear enough. In the old prescription the diuretic was given twice per day (once in the morning, once in the afternoon).

Contact me again, for any further questions you may have.

Kind Regards!

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Brief Answer:
I understand but the data are missing

Detailed Answer:
I understand your concerns and her situation. You have to understand though, that without careful dosage modifications your mother may suffer the same all over again. I mean the electrolyte disorders. One thing you could do, is to visit a lab and measure urea, creatinine, sodium, potassium and magnesium. The results would be very helpful.

Of course I could not give you a 100% proof advice about dosages without having lab results.

A good starting point is what I've written in my first answer. If you're concerned about hyperkalemia you can use less aldactone (take it once in the morning only).

Kind Regards!

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Brief Answer:
The hemoglobin itself is no reason to use aspirin

Detailed Answer:
Hi,
you're welcome!
Aspirin is not indicated due to the hemoglobin level, which is high. If the hemoglobin level was lower in the past (13 or 14 for example) then investigation would is needed. Rising hemoglobin levels can be attributed to various conditions like lung disease or hematologic conditions.

Aspirin is commonly prescribed in heart disease though, particularly in ischemic heart disease, which I suspect is this case. Since I don't know the exact diagnosis, I suggest you consult your cardiologist on that matter.

Kind Regards!

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