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Mom Is 94... One Kidney....has Congestive Heart Failure . About
Question: Mom is 94... one kidney....has congestive heart failure. About 3 months ago, was very short of breath and wheezing... fluid in feet... no fever...had thoracentisis to get 1/3 liter of fluid off of area between chest wall and lung. Remarkable improvement within a week. A few months pass... doing really good...Recently , she is having again really bad SOB and wheezing... oxygen level dropping...blood test showed increased kidney function drop to 1.8.....
Went to new heart failure expert... he said she has pulmonary hypertension... he told her we have to get pressure (usually 170s over 60) down AND get fluid off.....
Said to take
1. 40 mg lasix twice a day
2. Nifedipine -60 mg twice a day
3. Coreg ( carvedilol) 6.25 mg twice a day ( replaces metoprolol)
4. Losartan —-100 once a day ( same as before)
5. Clonidine —1 mg... if blood pressure is over 160
Dr.... is that a good plan to get fluid off and keep bp down????
Went to new heart failure expert... he said she has pulmonary hypertension... he told her we have to get pressure (usually 170s over 60) down AND get fluid off.....
Said to take
1. 40 mg lasix twice a day
2. Nifedipine -60 mg twice a day
3. Coreg ( carvedilol) 6.25 mg twice a day ( replaces metoprolol)
4. Losartan —-100 once a day ( same as before)
5. Clonidine —1 mg... if blood pressure is over 160
Dr.... is that a good plan to get fluid off and keep bp down????
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on -Ask a Doctor- service!
I passed carefully through your mom's medical history and would explain that keeping blood pressure under control and continuing diuretics therapy seems to be the right strategy for heart failure to stay compenstated; that is avoiding pleura fluid accumulation and peripheral edema.
Probably would be necessary to increase the daily diuretic dose and for that reason a close periodic folliwup is advisable.
In addition, another drug such as ARNI class may be recommended, if the actual therapy is not enough.
You need to discuss with the attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
If you have any further questions, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on -Ask a Doctor- service!
I passed carefully through your mom's medical history and would explain that keeping blood pressure under control and continuing diuretics therapy seems to be the right strategy for heart failure to stay compenstated; that is avoiding pleura fluid accumulation and peripheral edema.
Probably would be necessary to increase the daily diuretic dose and for that reason a close periodic folliwup is advisable.
In addition, another drug such as ARNI class may be recommended, if the actual therapy is not enough.
You need to discuss with the attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
If you have any further questions, feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr
It seems it is a large amount of lasix.... 40 mg—4 times a day ... is it a safe dose... mom has 1 kidney..a Recent creatinine was 1.8......
2) how much liquid should she drink in a day???
She gets dehydrated because she doesn’t drink fluids ... but we are trying to get fluid off....
It seems it is a large amount of lasix.... 40 mg—4 times a day ... is it a safe dose... mom has 1 kidney..a Recent creatinine was 1.8......
2) how much liquid should she drink in a day???
She gets dehydrated because she doesn’t drink fluids ... but we are trying to get fluid off....
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This is not a high dose of Lasix.
You should know that in heart failure, as she has leg swelling, there is increased fluid retention. She is not dehydrated as the fluid is not inside the arteries, but is extravasated due to increased venous pressure, as the heart does not pump properly blood from the venous system to the arterial system.
For this reason, it is important continue taking Lasix.
I would also recommend limit the salt intake. It is OK to take water as needed, to avoid dehydration as she is taking diuretics. She may take up to 1.5 liter of water per day, if she is thirsty.
I would also recommend discussing with her doctor on the possibility of taking an ARNI drug to improve her situation.
Hope to have been helpful to you!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This is not a high dose of Lasix.
You should know that in heart failure, as she has leg swelling, there is increased fluid retention. She is not dehydrated as the fluid is not inside the arteries, but is extravasated due to increased venous pressure, as the heart does not pump properly blood from the venous system to the arterial system.
For this reason, it is important continue taking Lasix.
I would also recommend limit the salt intake. It is OK to take water as needed, to avoid dehydration as she is taking diuretics. She may take up to 1.5 liter of water per day, if she is thirsty.
I would also recommend discussing with her doctor on the possibility of taking an ARNI drug to improve her situation.
Hope to have been helpful to you!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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