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My Mom Is 94...5 Feet Tall...106 Lbs...one Kidney....she Has Occasional
Question: My mom is 94...5 feet tall...106 lbs...one kidney....she has occasional atrial fibrillation , not constant... once every 2 Weeks—- lasting only 2 hours in length....
her cardiologist for her high blood pressure,recently put her on 100 mg of losartan...30 mg Nifedipine...50 mg metoprolol....and 25 mg hctz...since Putting her on these drugs , her bp has gone up...around 180 and 190s systolic.. diastolic has been normal... heart rate 60...today bp was 226/70
!!!.. and she was agitated and some confused........ I gave clonidine 0.1 mg and the blood pressure came down to 145/60/ with heart rate of 50 after 30 minutes....the systolic is the one that is elevated when she feels bad......
I called her doctor about what to do ....who said give clonidine “as needed”if the systolic over 180...increase Lasix to 40 mg...and take the others as stated above...
She has one kidney .... and I’m needing to see if you agree with the treatment....the meds...
Should I be doing anything else???
.....
her cardiologist for her high blood pressure,recently put her on 100 mg of losartan...30 mg Nifedipine...50 mg metoprolol....and 25 mg hctz...since Putting her on these drugs , her bp has gone up...around 180 and 190s systolic.. diastolic has been normal... heart rate 60...today bp was 226/70
!!!.. and she was agitated and some confused........ I gave clonidine 0.1 mg and the blood pressure came down to 145/60/ with heart rate of 50 after 30 minutes....the systolic is the one that is elevated when she feels bad......
I called her doctor about what to do ....who said give clonidine “as needed”if the systolic over 180...increase Lasix to 40 mg...and take the others as stated above...
She has one kidney .... and I’m needing to see if you agree with the treatment....the meds...
Should I be doing anything else???
.....
Brief Answer:
I would explain as follows :
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - sevice!
I understand your concern, and would like to explain that before modifying the actual therapy. it would be necessary to check her renal and thyroif function.
Some therapy optimisation could be helpful as follows:
- Losartan could be substituted by more potent vasodilators, such as Valsartan, Olmesartan, Irbesartan or Telmisartan,
- 50 mg Metoprolol could be substituted by 6.25 mg Carvedilol (divided twice daily),
- Instead of Lasix 40 mg, 25 mg Hydrochlorthiazid could be more effective,
-Clonidine 0.1 mg may be used in case of acute hypertension and aslo as a maintainance therapy twice daily.
You should discuss with her attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of 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 - sevice!
I understand your concern, and would like to explain that before modifying the actual therapy. it would be necessary to check her renal and thyroif function.
Some therapy optimisation could be helpful as follows:
- Losartan could be substituted by more potent vasodilators, such as Valsartan, Olmesartan, Irbesartan or Telmisartan,
- 50 mg Metoprolol could be substituted by 6.25 mg Carvedilol (divided twice daily),
- Instead of Lasix 40 mg, 25 mg Hydrochlorthiazid could be more effective,
-Clonidine 0.1 mg may be used in case of acute hypertension and aslo as a maintainance therapy twice daily.
You should discuss with her attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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