Age: 45 years gender: male diagnosis: HTN, NSTEMI, PCI Rx Tabnalapril 5 mg od Atenolol 50...

Age: 45 years

gender: male

diagnosis: HTN, NSTEMI, PCI

Tabnalapril 5 mg od

Atenolol 50 mg bid

Aspirin 75 mg od

Amlodipine 5 mg od

Clopidogrel 75 mg

Atorvastatin 10 mg od

GTN spry every 8 hrs

what the interactions in this case and what the alternative if there ?

if GTN spray not available, what you will recommended?

Solutions

Expert Solution

Here the patient is taking tablets such as Tab. Nalapril (Antihypertensive),Tab. Atenol (Anti hypertensive), Tab. Aspirin(Used to prevent blood clot formation), Tab. Amlodipine (Anti hypertensive), Tab. Atorva(Dyslipedimic agent) and GTN spray. All these drugs are used for improving the cardiac function of the patient.All these drugs May cause marked reduction of Blood pressure of patient with hypertension and to regulate the cardiac activity by preventing dysarrhythmias. The drug interaction can be as follows

The antihypertensive drugs may cause marked decrese in th BP, hence careful monitoring of BP is important.
Constantly monitor the renal function and conduct RFT at regular intervals.
Take the drug on regular time and at regualar dose.
Overdosage can results in marked hypotension
LFT should be carried out frequently, because the drug is usually metabolizes in liver.
Oral inake of aspirin may reduce the therapeutic effect of atenol. So closely monitor for any bleeding or any rise in the Blood pressure.
Clsely monitor the heart rate while using atenol for a long time.
Aspirin should be taken along with beta blockers for maximum effect.Together they reduces the elevated BP.
No interactions usuallt take place, when aspirin and atorva is taken together.

GTN spray is (Glyceryl Trinitrate spray) a commonly used drug in patients with Angina.Angina is acute chest pain usually develops in MI. This particular drug helps to relax and widen the blood vessels that supply blood to cardiac muscles, especially the coronary arteries , hence the blood flow to the heart muscles improves and patient experience reduction from his chest pain. In the absence of GTN spray the patient can take Nitroglycerin tablets. Which has got the same effect of this particular drug. If the patient is taking nitroglycerin tablets instead of GTN spray, advice them to take the first tablet, once when the symptoms of chest pain begins. Nitroglycerin tablets to be taken sublingually, not to be swallowed. Keep the first tablet under the tongue or in the buccal mucosa when the chest pain begins. The patient can take the second tablet if the pain not reduced in the second 5 minutes. Can take maximum of 3 tablets within 15 minutes, still the pain continue, they need to attend the hospital immediately.

Nightingale answered 1 year ago

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