heart/lung drug interactions

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

[Cleveland Clinic]

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

[Momto3]

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.

[lak]

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 (symptoms) 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.

[Momto3]

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?

[fearfactor]

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!

[upbeat63]

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!!

[kitcurious]

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

[Momto3]

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

[Momto3]

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

[fearfactor]

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

[Momto3]

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

[middy]

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

[Momto3]

I am so sorry to hear of battle with migraines.  Honestly, I think they are one of the most complex and frustrating disorders to treat.  

My daughter's migraines began in her late teens, early 20's and she had them in increasing frequency for about 3 years.  She had an especially difficult time during college - the pain and debilitation were incredible.  Very early on, OTC meds seemed to help.  Next, she tried Imitrex, then Zomig.  Imitrex did not work for her and Zomig helped a few times, but lost its effectiveness rapidly.  When the headaches became very frequent, I took her to a new internest and asked about trying Inderal.  Thank goodness, it worked for wonderfully for her.  Amazingly, when she weaned off of it one year later, the migraines did not return (except for on a rare occasion).  Just curious - what types of side effects did you experience from the BB's?  

I am appalled to hear that ANY doctor would dismiss the pain associated with a migraine!!  That's unbelievable!

Are you familiar with the use of Cafergot (caffeine RX) for migraines?  My mom took that for quite awhile until BB's became the preferred form of treatment.

I am a follower of the CCF Forum and am amazed at the medical issues you face at such a young age.  Though we have different histories and are YEARS apart in age (lol), we share the fact of falling prety to a "rare" cardiac event.  Thanks for sharing so much of your story and for your informative and thoughtful posts.  Hope 2006 finds you feeling better than ever!  

Connie

[PikaPika88]

I got the way to solve the migraine.  It is very effective for me.  It was told by my sister.

The body is too hot (not fever type), about the ying and yang.  You can buy herbal drink.  (10 packets for about AUD$1.40)  Or you can eat plenty of watermelon and/or cucumber.  (they're for cooling down the body heat.)  It means you need to drink a lot of water too.  I must take some herbal drink before and after eating the fried food, pizza and cookies.  Do not eat those which is come out right away.  Have to wait for a while then can eat.  Try that.  Good luck.

Pika.

[upbeat63]

I have heard that oxygen therapy works well for some migraine sufferers. I believe that your doctor can prescribe to you a small canister for home use and when you feel an migraine coming on, a few minutes of oxygen might help to prevent the attack or lessen the severity.

I've also known at least one person who had twice weekly disabling migraines that found the RX drug "neurontin" to be life changing. This is one of those drugs designed for a completely different use, but is showing good promise in chronic pain and now it appears possibly migraine reduction also.

I used to have migraines when I was in my teens, mostly the prodromes, luckily, and not the full blown attacks, but I have had a few of those lying writhing in pain in bed. I do understand.

I am curious about your statement about migraine sufferers going on to develop heart conditions. It seemed when I started getting the high frequency PVCs at age 18, the prodromes almost completely stopped. While I still get a few of the prodromes--occassionally, I never ever get a full migraine attack anymore.
hmm.