Heart Disease Expert Forum
AF & HTN medications
About This Forum:

This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

AF & HTN medications

My mom, 72 year old, female, with hypertension for 8 years (with medications, systolic 110-120). In May, while hospitalized due to methyldopa induced cholestasis, she was diagnosed with atrial fibrillation. In 8/09, 14 days into Warfain, she felt & suffered an acute subarachnoid & subdural hemorrhage.

In Dec, she has open cholecystectomy due to acute cholecystitis with pigmented gallstones.  

ECG results:
4/09: Sinus Bradycardia & Atrial Premature Complex
5/09: AF, T abnormalities
8/09: (hospitalized for CNS haemorrhages) Sinus rhythm
10/09: AF, T & ST abnormalities

Current Medications:
30 Amlodipine Besylate: 5 mg
Lisinopril: 40 mg
Atenolol: 50 mg
Omeprazole: 40 mg
Aspirin: 100 mg

She has no other risk, CHADS is "1".

1. Given her near-death bleed out, how safe is it to continue any blood-thinning therapy?

2. Are there any no problematic  drug interactions with her medications?  We are particularly concerned with some of the Atonolol’s side effects (i.e., the potential to develop type 2 diabetes, and unsteadiness when walking leading to more falls.)  Are there safer, just as effective alternatives to Atonolol for her?  We are also concerned with the elevated dosages of Lisinopril & Omeprazole. With these dosages, our mother’s systolic blood pressure has been in the lower end of below 120. Should the dosage be lowered, what should that be ?

Thank you.

1 Comment
Blank
242508_tn?1287427246
The atenolol and the lisinopril should be continued and they are safe at these doses unless she feels lots of lightheadedness.  The omeprazole helps with ASA tolerance.  

As far as the CNS bleeding, she obviously should never be on coumadin.  ASA has a lower risk of bleeding and is probably safe in her case.  I would confirm this with her neurologist or neurosurgeon.  

I would probably keep her regimen the way it is for now.
Blank
Continue discussion Blank
This Forum's Experts
Avatar_dr_m_tn
CCFHeart MD25Blank
Blank
Request an Appointment
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
How to Silence Your Inner Critic an...
Apr 16 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eaters: How to Silence Yo...
Mar 26 by Roger Gould, M.D.Blank
1344197_tn?1392822771
Blank
Vaginal vs. Laparoscopic Hysterecto...
Feb 19 by J. Kyle Mathews, MD, DVMBlank