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Heart Disease  (Expert Forum)
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heart/lung drug interactions
Answered by
Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

heart/lung drug interactions

by middy, Jan 09, 2006 12:00AM
I have some A-fib (30 day halter) and vaso-vagel syncope.  I also have COPD.  I have been taking inderal (20mg) for migraine and syncope.  The pulmonologist rx'd combivent 2 puffs 4 times a day.  The pharmacist said that is a bad interaction.  My heart doc said "ween off the inderal".   I've been on it 15 years and hesitate to do so.  What do you suggest?? I do need a broncodilator about 3 times a week.



Thank you,



Middy
Doctor's Answer

by Cleveland Clinic, Jan 09, 2006 12:00AM
middy,



thanks for the post.



Beta blockers can effect the reactivity of the airways in patients with asthma/copd and sometimes make symptoms worse.



Beta-adrenergic agents are used to stimulate airways patency with asthma/COPD and the 2 drugs counteract each other.  



I have patients on both and some patients can tolerate both so I wouldnt base it soley on the phamacist book. If you don not have an absolute reason to be on a beta blocker such as MI/CHF then a calcium channel blocker will probably suffice for rate control of your a fib.



gooc luck
Member Comments (15)

by Momto3, Jan 09, 2006 12:00AM
After trying several of the newer meds for migraines, I asked my daughter's physician about trying a beta blocker as a preventive measure (my mom had luck with Inderal).  Prior to the RX, my daughter was having at least 3 moderate-severe migraines/week for 1-2 years.  After one year on preventive treatment (Inderal), she weaned off the of RX and has been nearly migraine-free for a few years.  Although she gets an occasional migraine, she is able to better manage them.  



As for pvc control, I found Inderal to have mixed effects on my pvcs.  There were times when the medicine seemed to have a significantly positive effect.  While other times, the lower HR brought on by the BB seemed to exasberate them.



by lak, Jan 09, 2006 12:00AM
I was reading the last few days post and noticed that there was one where the patient said she had the tingling,lethargy.



I still have thousands of pvc's daily.  I get very lethargic and my hands and feet go completely to sleep.  The are so numb that it is actually painful until they come back.  Usually when I am sleeping.  I also retain alot of water. Sometimes 3-5 pounds.  Is there anyone else out there with these symptoms that have alot of pvc's?  Any comments would be appreciated. I am afraid of new syptoms but no insurance right now.  Trying to wait it out another month.................



Tickertock, your answer to that one post was, yes very gracious.  It is my understanding that this post is for helping eachother not just asking the doctor's questions.  There are alot of things we can help eachother with that maybe be have read in old posts.

by Momto3, Jan 09, 2006 12:00AM
To: lak
Do you have a structurally normal heart?  When I was having 22,000 pvcs/day, I developed cardiomyopathy.  It is a rare occurrence when someone has thousands of pvcs for a lengthy period of time (I'm told).  Anyway, when I had the CM, I had a problem with retaining water (legs and abdomen).  Have you had a recent exam/ echo?

by fearfactor, Jan 09, 2006 12:00AM
To: momto3
Hi Momto3 - sorry to "hijack" this thread for a minute but I just wanted to say HI to you and tell you I'm going to be a mother again.  I found out I'm PG with my 2nd over the holidays.  We are so happy, but I was just wondering - how were your PVCs during pregnancy?  Mine have actually been BETTER!  I am so shocked!  Hope this isn't just a fluke, and  continues!  Maybe it's the hormones, it seems when I have more estrogen I do better!

by upbeat63, Jan 09, 2006 12:00AM
To: Fearfactor
Just wanted to let you know that I had a doctor tell me once that my PVCs would get better (lessen in frequency) if I became pregnant.



Didn't want to at the time, so I never found out if pregnancy would reduce my PVCs. I'd have become a baby machine if I thought that was true, but it's too late for me now.



But I was told about the pregnancy/PVC frequency reduction by at least one MD, so just to let you know.



By the way, Congratulations!! and glad you've got some relief of those nasty PVCs. Hope school goes a little easier as a result too!!

by kitcurious, Jan 09, 2006 12:00AM
To: lak and tickertock
I agree that Tickertock's response was gracious. I hope my comment here isn't too stupid, but I was reading the previous exchange about people getting elevated BP from anxiety at the Doc's office. There is some device that takes a 24 hr. BP monitor ( I guess like a Holter for BP ?) that could give a more accurate indication of what a person's BP actually is. A pharmaceutical company used to loan one to my (and other) Cardiologist's office, but they stopped providing it. Gee, I wonder why they stopped? Let'see, they sell meds for high blood pressure and the 24 hr. monitor tells people whether or not they actually HAVE high blood pressure. Hmmmm

by Momto3, Jan 09, 2006 12:00AM
To: fearfactor
WOW!!!  That's fabulous news!!!  2006 is going to be a great year!!!  I'm so happy for you....Can you tell?  I love babies and kids!!!  We have 3 grown kids, and fostered many!!  Just love 'em....Hope the pregnancy, L&D and all that follow goes perfectly!!  CONGRATULATIONS!!!  You made my day....Are you still graduating this year?  



As for the pvcs...This is weird, but I didn't really notice them.  Then, I'm at the OB/GYN for the first overall PG checkup for baby one, and the doctor says something about an arrythmia...News to me, but I never followed up cuz I felt fine.  Second time around, the doctor drags in a tech with an EKG machine...says this time he's not lettin' me leave till he figures out what's up....Hmmmm....still news to me.  I guess I'd always attributed the "weird" feelings to anxiety.  Second PG is when I started seeing a cardio regularly and that was in 1982!!!  I didn't really notice that they went crazy during PG.  Now, the periM period, that's a whole 'nother story.



Please keep us in the loop about "babyfactor."  We'll leave out "fear" for baby....lol.  



Take care of yourself and enjoy the entire pregnancy!



Connie

by Momto3, Jan 09, 2006 12:00AM
To: upbeat63
The ablation seemed a better route to take than another pregnancy....lol!!  I miss having young kids around, but I still revel in their grownup antics : )



Hope you are doing well!



connie

by fearfactor, Jan 09, 2006 12:00AM
To: momto3, upbeat63
Thanks for the congratulations!  I am very excited and definitely hope this year is a better one for me, my family and hope and pray for a PAC and PVC-free year for everyone here!  I will keep you all updated on the baby!

Stacy

by Momto3, Jan 09, 2006 12:00AM
To: Al Dente
I believe a number of people commented on the use of BB's as a preventive medication for migraine headaches.  I don't think anyone here discounts the intense pain associated with migraine headaches. My daughter suffered a great deal with frequent migraines until she was prescribed Inderal.  



I completely understand the debilitating pain and sickness associated with migraines.  However, I also enjoy the opportunity to celebrate good news.



Hope you find relief from the migraines.  My grandfather, mother and daughter have all dealt with them.  I've always said that I'm very grateful for not having had them.  Take care.



Connie

by middy, Jan 09, 2006 12:00AM
To: Al Dente
I appreciate your response.  Atenolol is also a beta blocker and still interacts with a broncodialator (combivent) that I really need for my lung disease.



The dr. suggested a calcium channel blocker.  Unfortunately I tried several and had bad side effects, including a terrible cough.



Still looking for a solution.

Thanks,

Middy



by Momto3