Question: Patient is 72, recovering from massive
stroke (approx 2 months prior,). He has an irregular heart beat, and blood pressure readings avg 90/65 and is at home going through rehab. His EKG, and Doctors have noted, that he has AF. (en spanish arritmia fibralacion auricular) . He has had a history of
high blood pressure and had an event about 5 yrs prior to the stroke. Not sure what happen but his
heart rate and Blood pressure readings were extremely high. Currently, very little monitoring or blood work is being done. The patient can go monthly to the hospital for blood work. Since November the patient has been taking Amidorana , telmisartan/hidroclorotiazida and
rivaroxaban (dosages below). The
carbamazepine was just added as a sleep aid, and
Digoxin is a new medicine that the Doctors want to add to the "Cocktail". The patient is eating, has trouble sleeping, has aches and pains, and at times he is with us 100% (and even understand my terrible spanish) and other times he is in a confused state (5% to 15% of the time..best guess). We are seeking additional assistance in determining if this cocktail is advisable, and what monitoring we should be doing if we continue with this cocktail. In Mexico there isnt a lot of care taken in prescribing medicine monitoring, so its up to the family to make sure what is being done is correct. Medical treatment in Mexico is not really integrated like in the USA, so when another Dr visits the house or we go to the hospital we take stacks of papers etc.
Previous cocktail (Nov to present)
Amidorana 200 mg
telmisartan/hidroclorotiazida 40ngl
Xarelto rivaroxaban 20mg 1 pill a day
New cocktail (they want to start)
Amidorana 100mg
telmisartan/hidroclorotiazida 20 mg
Xarelto rivaroxaban 20mg 1 pill a day
carbamazepine (carbamazepina) 200 mg in the night
Digoxin (
Lanoxin Digoxina) 0.25 mg