Question

In: Nursing

Age: 85 years Gender: male diagnosis: HTN+CHF Rx Indapamide 2.5 mg daily Bisoprolol 5 mg bid...

Age: 85 years

Gender: male

diagnosis: HTN+CHF

Rx

Indapamide 2.5 mg daily

Bisoprolol 5 mg bid

Digoxin 0.25 mg bid

Aspirin 81 mg od

Nifedipine 10 mg od

Note: if bisoprolol not available in your pharmacy , what in the alternative?

according to this prescription find the mistakes, the interaction, dose , the toxicity level , antidotes , the counselling and what the suitable medication for this patient ?

Solutions

Expert Solution

Metoprolol can be used if bisoprolol is not available as bith are beta blockers.

Interactions- digoxin is not given with beta blockers as additive depressent effect on sa and av nodes can precipitate av block. Thiazides like indapamide cause hypokalemia so it potentiates digoxin toxicity.

Aspirin by inhibihing prostaglandin synthesis leads to sodium and water retention so decrease efficacy of antihypertensive and thiazides.

Antidotes-Digibind is digoxin antibodies used in severe case of digoxin toxicity. Potassium chloride is also used.

Counselling- patient should take drugs after food for slow absorption.

Patient should avoid stress as it can worsen the condition.

Yoga and meditation are highly recommended for betterment of condition.

High lipid food like potato chips,fast food should be avoided.

More salt should also be avoided as it worsen hypertension.

Fruits,salads and juice are recommended.

More strenous activities should be avoided as they increase load on heart.

Thus lifestyle changes can improve prognosis of patient.

Suitable medications for patient can be indapamide and digoxin.

Nifedipine shouldn't be used in ccf.


Related Solutions

Age: 63 years Weight: 85 Kg   Diagnosis: HTN Gender: female Rx Hydralazine 50 mg, bid, hs...
Age: 63 years Weight: 85 Kg   Diagnosis: HTN Gender: female Rx Hydralazine 50 mg, bid, hs Fluvastatin 80 mg, one tab od Spironolactone tab 25 mg, 1/2 tab bid Amitriptyline 25 mg, od all medication for 3 months Note: patient has sever muscle pain with fever, what is your advice? discuss this prescription and why give the patient this medication and what the recommendation for the patient?
Rx age: 45 years Gender: male Diagnosis: HTN Lsinopril T 10 mg , one-tab bid Omol...
Rx age: 45 years Gender: male Diagnosis: HTN Lsinopril T 10 mg , one-tab bid Omol 500 mg sos Bisacodyl 5 mg morning sediproct cream bid Note: patient uncontrolled HTN and persistent cough for 2 week according to this prescription find the mistakes, the interaction, dose of each medication , the toxicity level , antidotes and the counselling  for all medication
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 Rx 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?
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 Rx 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 Note: if GTN spray not available, what you will recommended? according to this prescription find the mistakes, the interaction, dose , the toxicity level , antidotes , the counselling and what the suitable medication for this patient ?
Rx age: 30 years Gender: female Diagnosis: HTN in pregnancy methyldopa T 500 mg bid lasix...
Rx age: 30 years Gender: female Diagnosis: HTN in pregnancy methyldopa T 500 mg bid lasix T 40 mg, 1/2 tab od valsartan 80 mg, 160 mg od ferrous sulphate 200 mg , tid Note: patient cannot tolerate ferrous sulphate. according to this prescription find the mistakes, the interaction, dose of each medication , the toxicity level , antidotes and the counselling  for all medication
Age: 45 year Gender: Male Diagnosis: Angina.P. Rx Trimetazidine tablets 35 mg MR , 1 bid...
Age: 45 year Gender: Male Diagnosis: Angina.P. Rx Trimetazidine tablets 35 mg MR , 1 bid Atenolol 100 mg , 1/2 tablet od Isoket 10 mg Tid according to this prescription find the mistakes, the interaction, dose for adult and Paediatric , the toxicity level , antidotes , follow up,  the counselling and what the suitable medication for this patient ?
Age: 39 years Gender: Female Diagnosis: DVT with Arrythmia Rx Warfarin Tab 1 mg , one...
Age: 39 years Gender: Female Diagnosis: DVT with Arrythmia Rx Warfarin Tab 1 mg , one od Warfarin Tab 5 mg , 1.5 tab od Furosemide tabs 40 mg , 1.5 od Aspirin Tab 75 mg, one od Ketoprofen gel prn Amiodaron 200 mg od Note: what are the new anticoagulants? differentiate between them and warfarin? according to this prescription find the mistakes, the interaction, dose for adult and Paediatric , the toxicity level , antidotes , follow up,  the counselling...
Age: 63 years Diagnosis: asthma Gender: female Rx Symbicort Turbohaler 160/4.5 mcg 1 puff bid for...
Age: 63 years Diagnosis: asthma Gender: female Rx Symbicort Turbohaler 160/4.5 mcg 1 puff bid for 90 days Beclomethasone MDI 2 puff PRN for 90 days Theophylline 1 tabs bid for 90 days Co-codaprin for back pain 1 tabs prn for 5 days discuss this prescription and why give the patient this medication and what the recommendation for the patient?
Age: 26 day Gender: female Diagnosis: PUD in nursing mother Rx Omeprazole T one od Note:...
Age: 26 day Gender: female Diagnosis: PUD in nursing mother Rx Omeprazole T one od Note: urea breath test was +ve , patient is allergic to penicillin. according to this prescription find the mistakes, the interaction, dose , the toxicity level , antidotes , the counselling and what the suitable medication for this patient ?
44-year-old male ETOH Abuse Smokes 1ppd for 30 years PMH: COPD, DM, HTN, CHF, Cirrhosis, Ascites,...
44-year-old male ETOH Abuse Smokes 1ppd for 30 years PMH: COPD, DM, HTN, CHF, Cirrhosis, Ascites, BPH PSH: TURP, Repair of right inguinal hernia, Cholecystectomy Allergies: PCN The above patient came to the ED c/o, spitting up blood and altered mental status. VS 103.5 – 189/103 – 114 – 26 – 89% NRB. The patient was intubated and vented, and NGT was placed. When lungs were auscultated, there crackles heard halfway up. Line and labs were done, and IVF 0.45...
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT